1
|
Uesugi‐Uchida S, Oyama N, Yoshida Y, Hasegawa M. Efficacy of topical adapalene monotherapy for symptomatic relief in a long‐standing vulvar syringoma: A case report and literature review with treatment update. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2021. [DOI: 10.1002/cia2.12216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Saori Uesugi‐Uchida
- Department of Dermatology Division of Medical Sciences University of Fukui Fukui Japan
| | - Noritaka Oyama
- Department of Dermatology Division of Medical Sciences University of Fukui Fukui Japan
| | - Yoshio Yoshida
- Department of Gynecology Division of Medical Sciences University of Fukui Fukui Japan
| | - Minoru Hasegawa
- Department of Dermatology Division of Medical Sciences University of Fukui Fukui Japan
| |
Collapse
|
2
|
Algeri P, Rodella R, Manfredini C, Algeri M. An Unusual Case of Genital Lesion: A Vulvar Syringoma. J Family Reprod Health 2021; 15:70-73. [PMID: 34429739 PMCID: PMC8346743 DOI: 10.18502/jfrh.v15i1.6080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: Syringoma is a benign adnexal neoplasm of sweat gland, usually presenting as extra-genital lesions, while vulvar localization is rare. Moreover, syringoma is an uncommon vulvar neoplasms. Case report: A 44-year-old woman with previous diagnosis of duodenal gastrointestinal stromal tumour, underwent a local surgical excision for an isolated, painful, vulvar lesion. The specimen was submitted for histological examination. A vulvar syringoma was diagnosed. Conclusion: We describe this case according on its rarity and atypical presentation as well; therefore, vulvar neoplasms encompass many differential diagnoses, among which the incidence rate of syringoma is very low. Although its rarity, syringoma should be included among the differential diagnosis for vulvar neoplasm.
Collapse
Affiliation(s)
- Paola Algeri
- Department of Obstetrics and Gynaecology, Bolognini Hospital, ASST Bergamo est, Seriate, Bergamo, Italy
| | - Rosita Rodella
- Department of Pathological Anatomy, Bolognini Hospital, ASST Bergamo est, Seriate, Bergamo, Italy
| | - Cinzia Manfredini
- Department of Pathological Anatomy, Bolognini Hospital, ASST Bergamo est, Seriate, Bergamo, Italy
| | - Maurizio Algeri
- Department of Obstetrics and Gynaecology, Locatelli Hospital, ASST Bergamo est, Piario, Bergamo, Italy
| |
Collapse
|
3
|
Aksoy Sarac G, Onder M. An alternative for the treatment of vulvar syringoma: 577 nm pro-yellow laser. J Cosmet Dermatol 2021; 20:3931-3933. [PMID: 33905611 DOI: 10.1111/jocd.14186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/03/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Syringoma is a benign sweat gland tumor. AIM Vulvar location of syringoma is rare. Although the lesions are asymptomatic, it requires treatment due to the cosmetic concerns. PATIENTS/METHODS We present a 42-year-old woman with vulvar syringoma. RESULTS The patient treated with 577 nm pro-yellow laser with a great success. CONCLUSION A 577 nm pro-yellow laser is a good alternative in the treatment of vulvar syringoma.
Collapse
Affiliation(s)
- Gulhan Aksoy Sarac
- Ufuk University Faculty of Medicine Department of Dermatology, Ankara, Turkey
| | - Meltem Onder
- Gazi University Faculty of Medicine Department of Dermatology Emeritus Professor, Ankara, Turkey
| |
Collapse
|
4
|
Coexistence of Adult Onset Eruptive Syringoma and Bilateral Renal Cell Carcinoma: A Case Report. Am J Dermatopathol 2016; 39:56-58. [PMID: 27922891 DOI: 10.1097/dad.0000000000000592] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Eruptive syringoma is an unusual variant of syringoma, which usually presents before or during puberty. It typically occurs in large numbers as multiple yellow-brown-colored papules, which may show spontaneous regression. Because some authors have proposed that it could present as a reactive process of eccrine ducts to an inflammatory reaction caused by an unknown trigger, the exact pathomechanism is still unclear. There are also reports in the literature on the association of eruptive syringoma in Down syndrome, diabetes, milium, sarcoidosis, and psychiatric disorders. Some reports in the literature highlighted the association of eruptive syringomas and neoplasms. We describe here a case of adult-onset eruptive syringoma in a 53-year-old man and discuss the possibility of its association with renal cell carcinoma as a paraneoplastic phenomenon.
Collapse
|
5
|
Vulvar Syringomas in a Child: An Unusual Cause for a Common Symptom From the ISSVD Case Consultation Committee. J Low Genit Tract Dis 2016; 20:e55-6. [PMID: 27428607 DOI: 10.1097/lgt.0000000000000235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
6
|
Williams K, Shinkai K. Evaluation and management of the patient with multiple syringomas: A systematic review of the literature. J Am Acad Dermatol 2016; 74:1234-1240.e9. [PMID: 26850654 DOI: 10.1016/j.jaad.2015.12.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 12/01/2015] [Accepted: 12/05/2015] [Indexed: 11/24/2022]
Abstract
Syringomas are benign adnexal tumors with distinct histopathologic features, including the characteristic comma ("tadpole") shaped tail comprised of dilated, cystic eccrine ducts. Clinically, syringomas typically present in adolescent females predominantly in the periorbital region. They may present as solitary or multiple lesions, and more rare sites of involvement include the genitals, palms, scalp, and the chest. Over the past 50 years, there have been >800 reported cases of syringoma either alone or in conjunction with a systemic syndrome, most commonly Down syndrome. The primary aim of this systematic review is to discuss the clinical features and associations of syringomas with a focus on the patient with multiple syringomas. Its secondary aims are to explore pathophysiology with a focus on multiple syringomas and provide comprehensive data on both traditional and novel treatments. Importantly, multiple syringomas present across a broad clinical spectrum. Though noted in many textbooks to be related to tumor syndromes, the association of syringomas with inherited tumor syndromes is only rarely reported in the literature. Despite multiple reported cases of syringoma, the pathophysiology remains poorly understood and treatment continues to pose a significant challenge.
Collapse
Affiliation(s)
- Kiyanna Williams
- University of California San Francisco School of Medicine, San Francisco, California
| | - Kanade Shinkai
- Department of Dermatology, University of California San Francisco, San Francisco, California.
| |
Collapse
|
7
|
Rao AG. Unilateral Ulcerating Clear-Cell Syringomas Involving Left Groin in a Non-Diabetic Woman - Report of a Rare Presentation. Indian J Dermatol 2015; 60:420. [PMID: 26288433 PMCID: PMC4533563 DOI: 10.4103/0019-5154.160517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Clear-cell syringomas, a rare histologic variant of syringomas, frequently coexist with diabetes mellitus. Clinically, it presents as skin colored papules distributed symmetrically around periorbital region. However, asymmetrical distribution of syringomas is rare and much rarer is the ulceration in such syringomas. Ulceration in such asymmetrical syringomas has not been reported so far. Herein, we report ulceration of clear-cell syringomas involving left groin in a middle aged non-diabetic woman.
Collapse
|
8
|
Baker GM, Selim MA, Hoang MP. Vulvar Adnexal Lesions: A 32-Year, Single-Institution Review From Massachusetts General Hospital. Arch Pathol Lab Med 2013; 137:1237-46. [DOI: 10.5858/arpa.2012-0434-oa] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—Because the skin and modified mucosal surfaces of the vulvar region contain dense apocrine glands and anogenital mammary-like glands, in addition to eccrine glands and folliculosebaceous units, benign as well as malignant lesions derived from these adnexal structures are, not surprisingly, found in the vulva. However, their incidence occurring in the vulva has not been reported, to our knowledge.
Objective.—To determine the incidence of various vulvar adnexal lesions.
Design.—We performed a retrospective review (1978–2010) of the cases at our institution.
Results.—A total of 189 vulvar adnexal lesions were identified. Most of these lesions were benign (133 of 189; 70%), with hidradenoma papilliferum being the most common, followed by syringoma and various types of cysts. Rare cases of tubular adenoma, poroma, spiradenoma, hidradenoma, cylindroma, sebaceoma, and trichoepithelioma were identified. Malignant adnexal neoplasms comprised the remaining 30% (56 of 189) of the cases. Extramammary Paget disease was the most common (49 of 56), and 29% (14 of 49) demonstrated an invasive component. Rare cases of basal cell carcinoma, sebaceous carcinoma, apocrine carcinoma, adenoid cystic carcinoma, and spiradenocarcinoma were identified.
Conclusions.—In this retrospective review, we identified several benign entities that have not been previously reported on the vulva, namely pilomatricoma, poroma, spiradenoma, and sebaceoma. Hidradenoma papilliferum and extramammary Paget disease were the most common benign and malignant adnexal neoplasms, respectively. The spectrum of various vulvar adnexal lesions appears to reflect the frequency of the underlying glandular elements.
Collapse
Affiliation(s)
- Gabrielle M. Baker
- From the Department of Pathology, Harvard Medical School and Massachusetts General Hospital, Boston (Drs Baker and Hoang); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Selim)
| | - M. Angelica Selim
- From the Department of Pathology, Harvard Medical School and Massachusetts General Hospital, Boston (Drs Baker and Hoang); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Selim)
| | - Mai P. Hoang
- From the Department of Pathology, Harvard Medical School and Massachusetts General Hospital, Boston (Drs Baker and Hoang); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Selim)
| |
Collapse
|
9
|
Müller CSL, Tilgen W, Pföhler C. Clinicopathological diversity of syringomas: A study on current clinical and histopathologic concepts. DERMATO-ENDOCRINOLOGY 2011; 1:282-8. [PMID: 21572872 DOI: 10.4161/derm.1.6.10641] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Accepted: 11/17/2009] [Indexed: 11/19/2022]
Affiliation(s)
- Cornelia S L Müller
- The Saarland University Hospital; Department of Dermatology; Homburg/Saar, Germany
| | | | | |
Collapse
|
10
|
Abstract
Syringomas are benign, eccrine, sweat gland tumors that clinically appear as small skin-colored or yellow papules. Eruptive syringomas are rare variants that typically develop on the body's cutaneous anterior surface. Syringomas on the genital area have rarely been reported, although several authors maintain that syringoma should be considered in the differential diagnosis of pubic pruritic papular dermatitis. We present a case of a 31-year-old man with multiple, eruptive, asymptomatic papules involving the pubic area developed after waxing of the zone. Histological examination revealed disseminated syringomata. We postulate that the lesions were induced by depilation with a subsequently reactive inflammatory process resulting in a hyperplastic reaction of the eccrine ducts. This case supports the previous hypothesis suggesting that some of the so-called "eruptive syringomas" may start as a primary inflammatory eccrine reaction.
Collapse
|
11
|
Kavala M, Can B, Zindanci I, Kocatrk E, Trkolu Z, Bykbabani N, Ko M. Vulvar pruritus caused by syringoma of the vulva. Int J Dermatol 2008; 47:831-2. [DOI: 10.1111/j.1365-4632.2008.03664.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
12
|
Abstract
Syringomas are benign tumors of the eccrine sweat gland that are most common to the periorbital location. Less common and under-recognized is their potential involvement of the vulvar skin, where they may cause significant pruritus. In this location, lesions often develop just prior to or during puberty, with symptoms of pruritus sometimes correlating with pregnancy or menstruation. A hormonal influence has thus been postulated. Reported treatments for symptomatic patients include topical corticosteroids, systemic and topical antihistamines, laser and excisional surgery, cryotherapy, and topical atropine, with variable results. We report a 9-year-old girl who had severe pruritus secondary to syringomas of the vaginal labia, and review the literature on this unusual disorder. Awareness of this condition is important in order that patients receive appropriate evaluation and management of their symptoms.
Collapse
Affiliation(s)
- Mary Garman
- Department of Dermatology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | | |
Collapse
|
13
|
Yoshii N, Kanekura T, Churei H, Kanzaki T. Syringoma-like eccrine sweat duct proliferation induced by radiation. J Dermatol 2006; 33:36-9. [PMID: 16469082 DOI: 10.1111/j.1346-8138.2006.00006.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report a 45-year-old woman with breast cancer who had undergone surgery and radiation and anti-estrogen therapy and presented with many reddish papules in the irradiated breast area. Skin biopsy of the affected area disclosed proliferation of eccrine sweat ducts and cystic structures; the clinical and histopathological features were consistent with syringoma-like eccrine sweat duct proliferation. The lesions spread rapidly on her chest during radiation therapy and regressed spontaneously 3 weeks after its completion. We postulate that the lesions were induced by radiation, and promoted by anti-estrogen therapy.
Collapse
Affiliation(s)
- Noriko Yoshii
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
| | | | | | | |
Collapse
|
14
|
Bal N, Aslan E, Kayaselcuk F, Tarim E, Tuncer I. Vulvar syringoma aggravated by pregnancy. Pathol Oncol Res 2003; 9:196-7. [PMID: 14530816 DOI: 10.1007/bf03033738] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2003] [Accepted: 06/12/2003] [Indexed: 10/20/2022]
Abstract
Syringoma is a benign tumors of eccrine sweat gland. They appear as multiple, tiny, firm, skin-colored papules. Vulvar involvement of syringoma is rare. Only 24 cases with vulvar syringoma have been previously reported in the literature. The majority of patients with vulvar syringomas are asymptomatic. A case of syringoma of the vulva exacerbated during pregnancy is presented. The case appears remarkable for the experienced aggravated pruritic symptoms of the patient during her pregnancy.
Collapse
Affiliation(s)
- Nebil Bal
- Department of Pathology, Baskent University Faculty of Medicine, Adana Teaching and Medical Research Center, Adana, Turkey.
| | | | | | | | | |
Collapse
|
15
|
Huang YH, Chuang YH, Kuo TT, Yang LC, Hong HS. Vulvar syringoma: a clinicopathologic and immunohistologic study of 18 patients and results of treatment. J Am Acad Dermatol 2003; 48:735-9. [PMID: 12734503 DOI: 10.1067/mjd.2003.285] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Syringoma of the vulva has been rarely reported. No effective treatment modality has been documented. OBJECTIVE The purpose of this study was to describe the clinicopathologic features of vulvar syringoma, to investigate the hormonal influence on its growth, and to establish an effective treatment modality. METHODS A total of 18 cases of vulvar syringoma were selected from the surgical pathologic file at Chang Gung Memorial Hospital. In all, 15 formalin-fixed, paraffin-embedded specimens were examined by immunohistochemical staining for estrogen receptor and progesterone receptor. RESULTS The age of first presentation at our vulvar clinic ranged from 21 to 60 years with a median age of 29.5 years. Of patients, 13 (72%) had vulvar pruritus and 7 noticed aggravation during summer or during menstruation. The most common clinical appearance was multiple flesh-colored or brownish papules on bilateral sides of the vulva (9 of 18). One third of our series was found to have coexisting eyelid syringoma and 4 of them also had a family history of periorbital syringoma. Immunohistochemical stainings for estrogen receptor and progesterone receptor were all negative on the 15 cases studied. Of our patients, 7 with intense pruritus were treated with carbon dioxide laser vaporization. Their lesions resolved and pruritus subsided. CONCLUSION Vulvar syringoma is not very rare and should be considered in the differential diagnosis of vulvar pruritus. In our study, estrogen receptor and progesterone receptor were not detected in vulvar syringoma. Carbon dioxide laser was an effective therapeutic modality in treating patients with intractable symptoms.
Collapse
Affiliation(s)
- Yu-Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Taipei, Taiwan
| | | | | | | | | |
Collapse
|
16
|
Guitart J, Rosenbaum MM, Requena L. 'Eruptive syringoma': a misnomer for a reactive eccrine gland ductal proliferation? J Cutan Pathol 2003; 30:202-5. [PMID: 12641781 DOI: 10.1034/j.1600-0560.2003.00023.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Syringomas have traditionally been categorized as benign neoplasms of the eccrine gland ductal epithelium. However, the variety of clinical presentations reported in the literature and some cases recently observed by the authors cast doubt upon the neoplastic nature of eruptive syringomas. Our goal is to challenge the traditional notion that eruptive syringomas are neoplastic lesions. RESULTS We observed two patients who presented with an eczematous process, which resolved leaving residual lesions. Biopsies of the late lesions showed features of eccrine syringoma. Yet a biopsy obtained from an incipient lesion in one of the cases showed a lymphocytic inflammatory reaction of the superficial portion of the eccrine duct resulting in tortuous hyperplastic changes. CONCLUSION Based on our observations, some of the so-called 'eruptive syringoma' may represent a hyperplastic response of the eccrine duct to an inflammatory reaction rather than a true adnexal neoplasm. We proposed the term 'syringomatous dermatitis' for such cases.
Collapse
Affiliation(s)
- J Guitart
- Department of Dermatology, North-western University Medical School, Chicago, IL 60611, USA.
| | | | | |
Collapse
|
17
|
Peterdy GA, Huettner PC, Rajaram V, Lind AC. Trichofolliculoma of the vulva associated with vulvar intraepithelial neoplasia: report of three cases and review of the literature. Int J Gynecol Pathol 2002; 21:224-30. [PMID: 12068167 DOI: 10.1097/00004347-200207000-00004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Trichofolliculoma is an uncommon, benign cutaneous adnexal neoplasm most commonly occurring on the head and neck. Trichofolliculoma of the vulva has not been previously reported. The juxtaposition of a trichofolliculoma in an excisional biopsy specimen performed for vulvar intraepithelial neoplasia (VIN III) created a diagnostic dilemma and prompted a review of our files from 1989 to 2000 for additional cases. A search for benign hair follicle tumors of the vulva identified two additional trichofolliculomas. All three vulvar trichofolliculomas were associated with VIN III. During this same period, 628 cases of vulvar intraepithelial neoplasia II and III were identified. The appearance of trichofolliculoma at this previously unreported site may present diagnostic difficulty.
Collapse
Affiliation(s)
- G A Peterdy
- Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St. Louis, Missouri 63110, USA
| | | | | | | |
Collapse
|
18
|
Yorganci A, Kale A, Dunder I, Ensari A, Sertcelik A. Vulvar syringoma showing progesterone receptor positivity. BJOG 2000; 107:292-4. [PMID: 10688518 DOI: 10.1111/j.1471-0528.2000.tb11705.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Yorganci
- Department of Obstetrics and Gynaecology, Ankara University School of Medicine, Turkey
| | | | | | | | | |
Collapse
|