DermDx: Flesh-Colored Lesion Above Lip

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A 57-year-old woman requests removal of a small flesh-colored lesion above her lip, which she reports has been present for several years. The site has remained asymptomatic. The patient has no history of skin cancer and is currently taking medications for control of thyroid disease and hypertension. Physical examination reveals a 3-mm flesh-colored papule that is firm on palpation.

Biopsy of the lesion revealed a syringoma. A syringoma is a benign neoplasm that arises from the eccrine intraepidermal ductal epithelium.1 The name is derived from the Greek word syrinx meaning pipe or tube.2 Lesions present as firm, skin-colored to...

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Biopsy of the lesion revealed a syringoma. A syringoma is a benign neoplasm that arises from the eccrine intraepidermal ductal epithelium.1 The name is derived from the Greek word syrinx meaning pipe or tube.2 Lesions present as firm, skin-colored to slightly pigmented papules measuring 1 to 3 mm in size. These lesions are more common in women and may appear as early as puberty.2 Lesions frequently occur about the eyes although case reports have documented syringomas of the axillae, vulva, and penis.3  

The lesions are asymptomatic but cosmetically disfiguring. Destructive treatment with electrodessication or ablative lasers is standard therapy but may leave post-inflammatory hyperpigmentation in darker-skinned individuals.

Generalized eruptive syringoma is a rare variant that affects multiple body parts including the chest, neck, trunk, and extremities.4 Lesions may arise in crops during childhood or teenage years. The condition may be familial or associated with Down syndrome and Ehlers-Danlos syndrome. Response to isotretinoin has been reported in cases of eruptive syringoma.5,6

Stephen Schleicher, MD, is director of the DermDox Dermatology Centers, associate professor of medicine at Geisinger Commonwealth Medical College, and clinical instructor of dermatology at Arcadia University and Kings College.

References

1. Patterson JW. Benign sweat gland tumors: syringoma. In: Patterson JW, Hosler GA, eds. Weedon’s Skin Pathology. 4th ed. Churchill Livingstone; 2016:936.

2. A to Z Skin Diseaes. Syringoma. The Australasian College of Dermatologists. Accessed November 11, 2022. https://www.dermcoll.edu.au/atoz/syringoma/

3. 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(6):1234-1240.e9. doi:10.1016/j.jaad.2015.12.006

4. Yahya H. Generalized eruptive syringoma in a Nigerian Woman: a case report and a brief literature review. Niger J Clin Pract. 2021;24(8):1252-1254. doi:10.4103/njcp.njcp_438_19

5. Mainitz M, Schmidt JB, Gebhart W. Response of multiple syringomas to isotretinoin. Acta Derm Venereol. 1986;66(1):51-55.

6. Samia AM, Donthi D, Nenow J, Malik P, Prenshaw K. A case study and review of literature of eruptive syringoma in a six-year-old. Cureus. 2021;13(4):e14634.  doi:10.7759/cureus.14634

This article originally appeared on Clinical Advisor