Vulvar syringoma: a clinicopathologic and immunohistologic study of 18 patients and results of treatment.
BACKGROUND
Syringoma of the vulva has been rarely reported. No effective treatment modality has been documented.


OBJECTIVE
The purpose of this study was to describe the clinicopathologic features of vulvar syringoma, to investigate the hormonal influence on its growth, and to establish an effective treatment modality.


METHODS
A total of 18 cases of vulvar syringoma were selected from the surgical pathologic file at Chang Gung Memorial Hospital. In all, 15 formalin-fixed, paraffin-embedded specimens were examined by immunohistochemical staining for estrogen receptor and progesterone receptor.


RESULTS
The age of first presentation at our vulvar clinic ranged from 21 to 60 years with a median age of 29.5 years. Of patients, 13 (72%) had vulvar pruritus and 7 noticed aggravation during summer or during menstruation. The most common clinical appearance was multiple flesh-colored or brownish papules on bilateral sides of the vulva (9 of 18). One third of our series was found to have coexisting eyelid syringoma and 4 of them also had a family history of periorbital syringoma. Immunohistochemical stainings for estrogen receptor and progesterone receptor were all negative on the 15 cases studied. Of our patients, 7 with intense pruritus were treated with carbon dioxide laser vaporization. Their lesions resolved and pruritus subsided.


CONCLUSIONS
Vulvar syringoma is not very rare and should be considered in the differential diagnosis of vulvar pruritus. In our study, estrogen receptor and progesterone receptor were not detected in vulvar syringoma. Carbon dioxide laser was an effective therapeutic modality in treating patients with intractable symptoms.
Huang
Yu-Huei
YH
Department of Dermatology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Chuang
Ya-Hui
YH
Kuo
Tseng-tong
TT
Yang
Li-Cheng
LC
Hong
Hong-Shang
HS
D000328:Adult; D002245:Carbon Dioxide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053685:Laser Therapy; D008875:Middle Aged; D011379:Prognosis; D011537:Pruritus / Q000209:etiology / Q000473:pathology; D013544:Sweat Gland Neoplasms / Q000276:immunology / Q000473:pathology* / Q000601:surgery*; D018252:Syringoma / Q000276:immunology / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome; D014845:Vulvar Diseases / Q000175:diagnosis; D014846:Vulvar Neoplasms / Q000276:immunology / Q000473:pathology* / Q000601:surgery*
D002245:Carbon Dioxide