Syringomas are benign adnexal tumors derived from sweat glands. Usually, they occur as several papular lesions below the eyes. Rarely, they can occur more diffusely. When that occurs, the term eruptive syringomas is used.
The eruption of hundreds of tiny 1-2 mm flesh-colored to red-brown papules on the neck, chest and arms in a child or young adult is characteristic of this variant of syringomas. Syringomas may occur on the vulva as well. The association between syringomas and Down syndrome is seen in this variant. Familial cases may occur. Syringomas may rarely occur segmentally or in a linear fashion.
No reliable treatment is known. Isotretinoin has been tried with variable success. Topical tretinoin 0.1% cream Qday over 4 months produced flattening in one patient. Topical atropine (1%) in aqueous solution applied once daily alleviated the pruritus and decreased the size of the lesions in another patient [JAAD Volume 44, p148-149 January 2001] but this approach might be of concern given the risk of systemic absorption of the atropine.
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