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CASE REPORT
Year : 2020  |  Volume : 23  |  Issue : 2  |  Page : 273-274

Treatment of a case wıth gıant eyelıd syrıngomas


1 Department of Ophthalmology, Ufuk University, Ankara, Turkey
2 Department of Dermatology, Baskent University, Ankara, Turkey
3 Department of Pathology, Ufuk University, Ankara, Turkey

Date of Submission21-Feb-2019
Date of Acceptance11-Sep-2019
Date of Web Publication7-Feb-2020

Correspondence Address:
Dr. I Iritas
Yukari Bahcelievler Mah. 65. Sok. Yilmaz Apt: 19/6 06490, Cankaya/Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njcp.njcp_115_19

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   Abstract 


He had a history of multiple asymptomatic flesh-colored papules, which had slowly increased in number and coalesced into plaques, on both upper and lower eyelids. Some of the plaques were giant and mostly coalescent in nature. We excised surgically the giant plaques which were approximately 1.5-2 cm in diameter symmetrically from upper and lower eylids and the remaining plaques were left to be treated with cauterization. Histopathological examination revealed syringoma. Both of the eyelids were observed to have a cosmetically adequate appearence after the surgical intervention.

Keywords: Oculoplastic surgery, syringoma treatment, syringomas


How to cite this article:
Iritas I, Iritas S Y, Ozer P A, Umudum H. Treatment of a case wıth gıant eyelıd syrıngomas. Niger J Clin Pract 2020;23:273-4

How to cite this URL:
Iritas I, Iritas S Y, Ozer P A, Umudum H. Treatment of a case wıth gıant eyelıd syrıngomas. Niger J Clin Pract [serial online] 2020 [cited 2020 Feb 20];23:273-4. Available from: http://www.njcponline.com/text.asp?2020/23/2/273/277851




   Introduction Top


Syringomas are benign adnexal tumors with characteristic histopathologic properties deriving from intraepidermal eccrine ducts. Clinically, lesions appear as small, firm, flesh-colored or yellow asymptomatic papules, 1-3 mm in diameter, often in multiples with symmetric distribution.[1] Syringomas typically present in early adulthood with a female predominance. The most common site of localized involvement is periorbital, but they involve any body sites.[1] Therefore, it is common in ophthalmology clinics.

The clinical differential diagnosis of syringomas includes milia, xanthoma, hidrocystoma, trichoepithelioma, and xanthelasma, especially for lesions on the eyelids. Diagnosis is confirmed by distinct histopathologic features. The goal of syringoma treatment is to improve cosmetic appearance because these lesions are considered benign, nonprogressive, and typically asymptomatic.[2] Treatments for syringomas include the following: surgical excision, cauterization, electrodessication, cryosurgery, chemical peeling, and laser ablation.[3]

We present a male patient who has been treated succesfully with eyelid surgery.


   Case Report Top


A 50-year-old male has been refered to our ophthalmology department for histopathological diagnosis and surgical treatment. He had a history of multiple asymptomatic flesh-colored papules which had slowly increased in number and coalesced into plaques, on both upper and lower eyelids, for 10 years. There was no other abnormal systemic symptom nor was there a family history of a similar skin condition. Physical examination showed bilateral symmetrical ill-defined skin-colored plaques, 1.5-2 cm in diameter, with peripheral multiple 1-2 mm skin-colored papules on both upper and lower eyelids [Figure 1].
Figure 1: Sub epidermal localized proliferation HE, X2

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We excised surgically the giant plaques which were approximately 1.5-2 cm in diameter symmetrically from upper and lower eylids. Histopathological examination revealed syringoma [Figure 2], [Figure 3], [Figure 4]. Both of the eyelids were observed to have a cosmetically adequate appearence after the surgical intervention.
Figure 2: Tubular-like structures in dense sclerotic state HE, X10

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Figure 3: Tennis racket-like ductal structures consisting of two-storey cuboidal cells forming the lesion HE, X45

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Figure 4: Preoperative appearance of eyelids

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   Discussion Top


Syringomas are benign eccrine sweat gland tumors which present as multiple, small, yellowish or skin-colored papules, usually at the periorbital area. However, genitalia, trunk, scalp and acral sites have been reported.[4] Especialy periorbital syringomas are cosmetically unpleasant and therapeutically challenging benign tumors.[3]

Treatments for syringomas include the following: surgical excision, cauterization, electrodessication, cryosurgery, chemical peeling, and laser ablation. Unfortunately, non-surgical approach requires extended application times for multiple syringomas across a large area and the results are dependent on the caregiver's level of skill.[3] Scar and dispigmentation may remain.

Oculoplastic surgery for eyelid reconstruction is recommended in cases with giant syringomas, providing histopathological sampling. Electrocauterization can be an option for small sized eyelid tumors unless there is an excess skin in form of dermatochalasis to be removed in association to the elimination of the syringoma.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Friedman S, Butler D. Syringoma presenting as milia. J Am Acad Dermatol 1987;16:310-4.  Back to cited text no. 1
    
2.
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.  Back to cited text no. 2
    
3.
Soler-Carrillo J, Estrach T, Mascaro JM. Eruptive syringoma: 27 new cases and review of the literature. J Eur Acad Dermatol Venereol 2001;15:242-6.  Back to cited text no. 3
    
4.
Patrizi A, Neri I, Marzaduri S, Varotti E, Passarini B. Syringoma: A review of twenty-nine cases. Acta Derm Venereol 1998;78:460-2.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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