A 58-year-old postmenopausal woman presented with a 6-month history of an asymptomatic vulvar lesion progressively increasing in size. Clinical evaluation revealed the presence of a small, single, pink-yellowish papule, localized on the right labia majora (Fig 1).
The dermoscopic examination revealed multiple glittering yellow-whitish structures, round-shaped or oval, of various sizes, presenting either singly or in clusters over a fading pink background, associated with the presence of dotted and short linear vessels, patchy and clustered (Fig 2).
The histologic examination revealed eccrine ducts lined with 2 layers of cuboidal cells, tadpole appearance of duct, and dense fibrous stroma (Fig 3). These findings were consistent with the diagnosis of syringoma. Syringoma is a benign adnexal tumor deriving from intraepidermal eccrine ducts that occurs predominantly in young women.1 Syringomas appear as small, firm, skin-colored or slightly yellow, asymptomatic or less frequently pruritic, soft papules, often in multiples withKey message
Thus, a biopsy with microscopic examination is often warranted (Hoffman et al., 2020). Histopathologically, the dermis features eccrine, duct-like, tubular structures lined with two layers of cuboidal epithelium embedded in a fibrous stroma (Corazza et al., 2017; Gerdsen et al., 2002; Mahajan et al., 2012). If patients endorse significant pruritus, short courses of topical steroids and oral antihistamines may be trialed.
There are few dermoscopic reports of syringomas. Corazza and colleagues78 described an isolated lesion on the vulva with a homogeneous pinkish central area with multiple round yellow-whitish structures. Hayashi and colleagues79 observed, in a linear unilateral syringoma, a central homogeneous light brownish area with a delicate pigment network at the periphery.
Publication of this article was supported by 3Gen Inc.
Funding sources: None.
Conflicts of interest: None declared.
