Syringoma

Syringoma

Syringoma is benign adenoma intraepidermis ductal eccrine glands and tumor is classified in the less mature. There are two clinical forms, but there are other authors who divided them into three groups:

1. Syringoma periorbital (Periorbital Syrigoma)

2. Syringoma eruptive (Eruptive syringoma, Eruptive hidradenoma, Disseminated syringoma) 

3. Another variant: the linear form of unilateral or nevoid distribution, linear finite, limited to the scalp, limited to the vulva, limited to the distal extremity, lichen planus-like, the type of milia (milia like).

Clinical Manifestations

       The most common clinical form is periorbital form, and a common predilection periorbital first arise in the inferior / lower eyelids. More common in women than men, with the onset of puberty is the most common age, but other authors mention can arise at any age group and decades of 2 and 3 are the age group most common. The clinical manifestation of the lesion is flat papules papules-soft / soft solid, l-2mm diameter / 2-3mm, with colors generally like skin color (Skincolored) or slightly yellowish but can also be pinkish or brownish, especially in the area scattered petals eyes, neck, and can also be in the form of generalized ie chest, epigastric or abdominal area and can even also in the area of the penis, vulva and fingers. The most common clinical differential diagnosis is milia, and can also open plana and angiofibroma. or hyperplasia sebease, eruptive xanthomas, hidrostoma and acne vulgaris.

Histopathology

         Histopathologic Syringoma is the discovery of a large number of small ducts in the fibrous stroma with walls consisting of two rows of epithelial cells in many cases these cells flattened or flattened, sometimes epithelial cells on the line seemed hollow (vacuolated). Amorfic duct lumen containing debris. Also found in the epithelial strand solid and basophilic outside duct. Sometimes close epidermal cysts found in the lumina duct, filled with keratin and is limited to cells that contain keratohyalin granules. This keratin cysts resembling milia and sometimes rupture, causing foreign body reaction. In rare circumstances, the tumor cells look like the clear cells, as a result of the accumulation of glycogen. To ensure that the differentiation of eccrine origin of the tumor can be verified by immuno histo chemical examination.

Treatment

       The treatment of choice is the destruction of tumors, among others, by curettage, cautery can be done chemically, biopsy punching, electrodesication and defocused CO2 laser beam. Some recent Syringoma treatment techniques developed among others elektrodesikasi by using short bursts of high frequency low voltage electrode intralesional using a fine needle or needle epilation, or scanned CO2 laser and CO2 laser vaporization combination with trichloroacetic acid 50 applications give satisfactory results, without scarring da free lesion 24 months to 4 years. The main thing in this Syringoma management is to give confidence to the people that this disorder is not harmful so no aggressive action is required if the disorder is still little mentioned by the authors as a treatment option that is often best.


Source:
1. Pict: http://www.consultantlive.com/articles/hidrocystomas-and-syringomas/page/0/2