Skin nonmelanocytic tumor
Adnexal tumors
Sweat gland derived (apocrine & eccrine glands)
Syringoma
Author: Sara C. Shalin, M.D., Ph.D.
Topic Completed: 1 March 2017
Minor changes: 16 October 2020
Copyright: 2002-2020, PathologyOutlines.com, Inc.
PubMed Search: Syringoma [title]
Table of Contents
Definition / general | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Electron microscopy description | Molecular / cytogenetics description | Differential diagnosis | Additional referencesCite this page: Shalin S. Syringoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocyticsyringoma.html. Accessed October 21st, 2020.
Definition / general
- Most common clinical presentation on lower eyelids of women
- Also face, neck, vulva and dorsal, proximal and middle phalanges of hand (Dermatoendocrinol 2009;1:282); also eruptive forms (see eruptive syringoma below)
- Four clinical variants:
- Localized
- Familial
- Down syndrome associated
- Generalized (multiple and eruptive)
- Appears to derive from sweat duct ridge
- Malignant counterpart can be termed syringomatous carcinoma / sweat gland carcinoma
Eruptive syringoma
- Neck, anterior trunk, axilla, shoulder, anterior surfaces of arms, abdomen or pubic areas of young men or women
- May be reactive hyperplasia of eccrine glands, not neoplastic
Case reports
Eruptive syringoma
- 28 year old woman (Indian J Dermatol 2009;54:65)
Treatment
- Benign lesions do not require treatment but numerous lesions may be cosmetically concerning
- Local destructive methods to remove lesions: laser, dermabrasion, biopsy / removal, electrocoagulation
Clinical images
Images hosted on other servers:
Disseminated brownish papules
Eruptive syringoma:
multiple flat papules
on thighs
Gross description
- Flesh color to yellow, papular lesions, 1 - 3 mm
- Generally multiple
Microscopic (histologic) description
- Generally confined to the upper / superficial dermis and circumscribed / symmetric
- Composed of small ducts with narrow to slightly dilated lumen lined by two layer thick epithelium, often with comma shaped extensions (also referred to "paisley tie" pattern or "tadpole" pattern)
- May have clear cells (due to glycogen accumulation); clear cell syringoma is associated with diabetes
- Not infiltrative, no atypia, no mitotic figures, no local destruction
- Presence of infiltrative growth, desmoplastic stroma, destruction of normal dermal structures or epidermal involvement should prompt consideration of syringomatous carcinoma or other sweat gland derived carcinoma
Microscopic (histologic) images
Contributed by Angel Fernandez-Flores, M.D., Ph.D.
Various images
Images hosted on other servers:
Severe pruritus
Representative lesion
Facial syringoma
Amorphous material
Epithelial cords
Syringomatous pattern
Eruptive syringoma
Positive stains
- Immunohistochemistry generally not required for diagnosis
- Usually ductal lumens mark with CEA
- Often progesterone receptor positive
Electron microscopy description
- Eccrine origin
Molecular / cytogenetics description
- Multiple syringomas may be inherited in autosomal dominant fashion; linked to chromosome 16q22 (Br J Dermatol 2010;162:1083)
Differential diagnosis
Differential Diagnosis: Clinical:
Differential Diagnosis: Clinical:
Differential Diagnosis: Clinical:
- Basal cell carcinoma, infiltrative type
- Desmoplastic trichoepithelioma
- Microcystic adnexal carcinoma
- Sweat gland carcinoma, syringomatous carcinoma
Additional references
