Late-onset of eruptive syringomas: a diagnostic challenge

Abstract

Syringoma is a benign, adnexal tumor of the eccrine sweat gland ducts. Eruptive syringomas are a rare variant, occurring before or during puberty in most cases. A 57-year-old man was observed in our department, with a 10-year history of multiple brownish papules (1-4mm in diameter), localized on the neck, shoulders, trunk and axillae. The clinical diagnosis was cutaneous mastocytosis. Histopathological examination from a papule in the trunk was compatible with the diagnosis of syringoma. The patient was treated with isotretinoin, without any improvement. The clinical diagnosis of eruptive syringoma is diffi cult and histological examination is crucial for its diagnosis. Long-term morbidity is not associated with syringomas; they are treated for cosmetic reasons with unsatisfactory results.

Papular Eruptions in Adult Females

“…It affects 0.6% of the population and can be classified as localized, generalized, familial, or associated with Down syndrome [2,4,5]. The localized form is the most prevalent, often sporadic, and is characterized by periocular lesions [2,6,7]. …”

“…Differential diagnoses include the following: lichen planus, lichen nitidus, flat warts, pseudoxanthoma elasticum, Darier disease, eruptive xanthomas, eruptive vellus hair cysts, disseminated granuloma annulare, hyperplasia of the sebaceous glands, and milia [3,4,6,13]. Although infrequent, some familial cases of eruptive syringoma have been reported [4,7]. Rarely, it may compose the Nicolau-Balus syndrome, which also manifests with milia and atrophodermia vermiculata [4,14].…”

“…Furthermore, dilated ducts due to accumulation of eosinophilic secretion may be seen [3,4,6,11]. The different forms of presentation are indistinguishable histologically; therefore, clinical correlation is required in order to determine the classification [4,7,9]. …”

“…Treatment is usually specified for esthetic reasons, as the lesions tend to be stable without any significant pathological repercussions in the long term [3,7,9]. Rarely, spontaneous resolution may occur [4,9].…”

“…Eruptive syringoma should be integrated within the differential diagnosis of dermatoses manifesting with papular eruption, independent of the topography of lesions and the patient's age group [4,7]. …”