Multiple Syringomas

A 32-year-old woman became concerned about the numerous bumps on her upper face, which had been increasing in number for many years. Examination revealed clusters of 2- to 3-mm lesions-mostly monomorphic, flesh-colored papules lateral to the eyebrows and on the central forehead, inferior-medial eyelids, and upper cheeks. Some of the papules had a slight pink or yellow-brown appearance, and poorly demarcated brown patches (melasma) were noted on the cheeks. Drs Eric J. Lewis and Charles E. Crutchfield III of Minneapolis confirmed their clinical suspicion of multiple syringomas with a biopsy of a papule.

Syringomas are benign tumors thought to originate from eccrine gland ducts.¹ They are typically small, somewhat translucent discrete papules that may have a faintly pink, yellow, or brown appearance. Most often, the lesions occur on eyelids and upper cheeks but, in extensive cases, also may be found on the chest, upper arms, and abdomen. Syringomas appear after puberty and are most common in women. Although syringomas are asymptomatic, they may persist indefinitely and be of significant cosmetic importance. Treatment options include electrodesiccation, cryotherapy, and laser ablation. Drs Lewis and Crutchfield advise colleagues to proceed cautiously with therapy, however, because of the potential for scarring and postinflammatory hyperpigmentation. After this patient learned that her syringomas were not dangerous, she opted for treatment of the melasma.

REFERENCE:
1. Arnold HL, Odom RB, James WD. Andrews' Diseases of the Skin: Clinical Dermatology. 8th ed. Philadelphia:WB Saunders Co; 1990:791-793.