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INTRODUCTION: Syringomas are benign tumours that develop predominantly in the periorbital areas of women. As periorbital syringoma is adjacent to the appendages, Erbium YAG (Er:YAG) laser treatment should be an ideal tool for its precise ablation, although its use has not previously been reported. We retrospectively analysed our new ovoid-shape Er:YAG laser ablation method for the treatment of syringoma. MATERIALS AND METHODS: We developed an extirpation method in which multiple, 2- to 4-mm, egg-shaped ablation fields were created. This method was used to treat 49 patients, 35 of whom had predominantly accumulated syringomas, and 14 had disseminated syringomas. Treatment was repeated every 2 months. RESULTS: Our approach was successful in both disseminated- and accumulated-type syringoma as well as plaque-type syringoma, which is considered to be the most difficult to treat. After an average of 3.77 treatments, more than 75% of the syringoma in the treated area had disappeared in 43 of 49 patients. CONCLUSION: Our ovoid-shape ablation method gives good cosmetic results even in the most difficult type of syringoma.

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BACKGROUND: Pinhole method has been used to treat various types of scars and dermal tumors by making multiple small holes in target tissues of the deep dermis using an ablative 10,600-nm carbon dioxide (CO2) laser. OBJECTIVES: We prospectively investigated the efficacy and safety of using a CO2 laser to treat periorbital syringomas via the pinhole method. METHODS: A total of 29 patients with periorbital syringomas were treated with two sessions of CO2 laser treatment using the pinhole method at two-month intervals. Laser fluences were delivered under the following settings: pulse duration of 200 µs, frequency of 50 Hz, on time of 0.04, and an off time of 0.01. RESULTS: Among the 29 patients, 13 patients (44.8%) presented with small discrete papular syringomas, 10 (34.5%) had plaque-type lesions, and six (20.7%) had mixed lesions. Evaluation of the clinical results at 2 months after the second treatment session revealed marked clinical improvement (51-75%) in 10 of the 29 patients (34.5%), moderate clinical improvement (26-50%) in eight (27.6%), near-total improvement (≥ 75%) in seven (24.1%), and minimal improvement (0-25%) in four patients (13.8%). CONCLUSIONS: Our observations indicated that application of the pinhole method using a CO2 laser exerts positive therapeutic effects in Asian patients with periorbital syringomas.

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Benign skin diseases have seldom been treated with radiotherapy, unless resistant to other treatments. Eccrine syringofibroadenoma (ESFA) is a rare benign eccrine tumor. ESFA very rarely presents bilateral lesions, and seldom a nonsurgical treatment has been proposed. An exceptional case of bilateral ESFA of the foot is presented; radiotherapy was effective in treating both lesions with good cosmetic results.

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We experienced that two Japanese women diagnosed with syringoma, confirmed by a punch biopsy, were successfully treated with fractional resurfacing. Both clinical cases have had positive results after only a few treatments, with high patient satisfaction, not only for the improvement of syringoma, but also for the improvement of aging skin, and with no side effects. From that aspect, laser treatment with fractional photothermolysis may be considered to be one of the effective treatment methods for syringoma. Although fractional photothermolysis was originally developed for an aesthetic purpose, it also can be utilized for intractable skin disease, as demonstrated by taking the concept of fractional photothermolysis and the results from this study with skin biopsy.

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Presentamos el caso de una niña de tres años y medio diagnosticada de tumor de Wilms estadio IIIB que presentó, con relación a terapia combinada con citostáticos y radioterapia, unas placas eritematovioláceas distribuidas en las zonas de radiación que se identificaron en el estudio histopatológico como siringometaplasia escamosa ecrina (SEE). El fenómeno de evocación es una dermatitis inducida por fármacos que se produce sobre una zona de piel tratada con radioterapia. La radioterapia induce cambios celulares subclínicos que favorecen la aparición de un efecto tóxico, generalmente por agentes antineoplásicos. La SEE es una forma excepcional de expresión del fenómeno de evocación. (AU)

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