A Clinicopathologic Analysis of Eighty Patients with Syringoma

Background: Syringoma is a benign tumor of eccrine origin which occurs predominantly in women after puberty. Although it is found commonly in the dermatological practice, studies relative to large series of patients have rarely been reported in the literature. Objective: The purpose of this study is to describe general clinicopathologic features of syringoma and to compare clinical and histopathological features among various subtypes of syringoma. Methods: A total of 80 patients with biopsy-confirmed syringoma were included. Data reviewed were sex, age, age at onset, subjective symptoms, family history, accompanied diseases, color and size, location and distribution, clinical impressions, treatment and course of the disease. Histopathologic features studied include acanthosis, basal pigmentation, tadpole appearance, vacuolization of tumor cells, keratin-filled cysts, calcification, and proliferation of fibrous stroma. Results: 1. Male:female ratio was 1:4.7 and the mean age at onset was 29.1 years. 2. The most frequent site of involvement was upper or lower eyelids (68.8%), followed by forehead, temple, cheeks, chin, abdomen, upper extremities, neck, vulva and penis, axillae, lower extremities, and perianal skin. Fifty patients showed localized lesions whereas the other thirty patients were classified as having eruptive, generalized syringoma. 3. Twenty-one patients, most of them with vulvar syringomas, complained of itching. 4. Seven patients had a family history of syringoma. 5. Histopathologically, all the previously described features were found. Vacuolization of cells and keratin-filled cysts were not rarely seen and luminal calcification was found in 3 patients. Epidermal changes were associated with the presence of pruritus and stromal fibrosis was commonly found in patients with early onset or longer duration. 6. Clinical and histological features were similar between localized group and generalized group, except for the common presence of brownish lesions in patients with generalized syringoma. 7. Lesions were not resolved spontaneously and treatments were found to be unsatisfactory. According to the results, we conclude that syringoma manifests a wide variety of clinical and histopathological features and should be included in the differential diagnosis of various papular dermatoses.