Syringomas are benign tumours originating from the eccrine ducts. Lower eyelid is the commonest site of origin. Very few cases have been reported in literature till date. Histopathology demonstrates normal compressed eccrine ducts in the fibrous capsule along with tumour cells arranged in tubules and solid islands. This report describes a case of syringoma on the lower eyelid in a female patient.

Monkeypox was historically considered a zoonotic disease restricted to areas with an animal reservoir and with limited possibilities of human transmission. However, the recent increase in incidence in non-endemic areas, together with the demonstration of human transmission, has led to more attention being paid to this disease. We present the case of a 27-year-old man with cutaneous lesions and perianal ulcers, clinically suggestive of a viral disease. Monkeypox was demonstrated with PCR analysis. The histological features and differential diagnoses of monkeypox are discussed and the characteristic histopathological pattern of eccrine gland epithelium is described which, if found in an ulcerated lesion, should raise suspicion of monkeypox.

Skin is commonly affected by graft versus host disease (GVHD), a complication of bone marrow transplantation (BMT). One-third of hematopoietic cell transplantation recipients develop acute eruption classically described as folliculocentric, maculopapular, or morbilliform, in contrast to the more common chronic presentations of sclerotic, poikilodermic, or lichenoid dermatitides. With the wider use of non-myeloablative (reduced-intensity) transplant therapy, various atypical presentations can occur, representing a diagnostic challenge. Herein, we report an unusual case of chronic GVHD manifested by two distinct clinical and histopathological features lacking the classical presentation. Five months after her BMT, the patient presented with a papulosquamous eruption on her neck, trunk, and arms showing a psoriasiform histopathological pattern of chronic GVHD. She also demonstrated multiple small flesh-colored papules on her distal extremities showing a solitary syringotropic pattern of GVHD, demonstrated by interface dermatitis involving the superficial eccrine duct, as the only diagnostic histopathological feature of GVHD. This report, with review of literature, highlights the uncommon psoriasiform GVHD and the novel description of isolated syringotropic chronic GVHD.

Background Syringoma is a benign adnexal neoplasm and is considered safe with very low malignant potential. However, multiple tiny lesions typically affect the face and exposed area, which may cause a cosmetic concern for the patient. After a clinical diagnosis, there are two methods to diagnose syringoma: fine needle aspiration cytology (FNAC) and histopathology. FNAC is generally used for the initial evaluation of syringoma, while histopathology is used as a confirmatory test to diagnose syringoma. In developing and resource-limited settings, the combination of FNAC and histopathology would cause a financial and logistics burden. Objective This study aimed to observe the cytological and histopathological features of cases clinically diagnosed as syringomas in a tertiary care hospital to suggest the use of either FNAC or histopathology for diagnosing syringoma. Materials and Methods This cross-sectional observational study was conducted in the Department of Dermatology and Department of Pathology of a tertiary care hospital in eastern India from November 2021 to April 2022. Any clinically provisionally diagnosed case of syringoma was recruited for the study after obtaining informed consent for voluntary participation. With aseptic precautions, the tissue aspirates and punch biopsy were obtained in the Department of Dermatology and the samples were sent to the Department of Pathology. Cytological and histological examination was conducted by a single expert pathologist. Result A total of 50 cases (36 female, 14 male) with a median age of 23 years (range 10-40 years) were included in the study. A total of 43 cases were presented with papular lesions and seven with nodules. In the majority of the cases (40%), the lesion was in the eyelid followed by 26% in the arm. In FNAC, 22 cases were found to be benign adnexal lesions, 16 were suggestive of syringoma, eight were diagnosed as xanthoma, two were diagnosed as warts, and two cases were inadequate for opinion. Histologically, 42 cases were confirmed as syringoma, six were diagnosed as xanthoma, and two cases were diagnosed as warts. There was a significant difference between diagnosis by FNAC and histopathology (McNemar χ2 = 24.038, p-value = 0.0001). Conclusion We found that FNAC and histopathological diagnosis of syringoma may not be corroborative. Benign adnexal lesions are difficult to categorize by FNAC. Histopathological examination of clinically diagnosed cases of syringoma is of help for definitive diagnosis. Hence, FNAC may be avoided for saving time and discomfort for the patients and clinically diagnosed cases may be diagnosed by histopathological examination.

Syringomas are benign tumors originating from the intraepidermal portion of eccrine sweat ducts. A six-year-old African American female presented with multiple 2-3 mm hyperpigmented papules over the neck, upper chest, and axillae bilaterally. The lesions were non-tender, non-pruritic, and did not bleed when lightly scraped. A café-au-lait macule was incidentally found in the mid-back of the patient. Histopathologically, multiple small ducts displaying a tadpole-shaped/paisley-tie pattern with fibrotic stroma were identified on hematoxylin and eosin staining. Epithelium showing nests of cells with basaloid appearance and dilated glands filled with eosinophilic material were also identified. These histopathologic findings were consistent with a diagnosis of eruptive syringoma. The patient was treated conservatively, and the lesions subsided without intervention. In most patients requesting treatment, isotretinoin is used; however, this may be an unnecessary measure in many patients. Overall, this case was significant due to the patient\'s young age, ethnicity, and clinical improvement in the absence of treatment.

BACKGROUND: Eccrine duct dilatation (EDD) has been noted to occur significantly more often in primary lymphocytic scarring alopecias compared with non-scarring alopecias, thus serving as a possible histopathologic marker for primary scarring alopecias with a lymphocytic infiltrate. This study aims to determine the presence and role of EDD in primary neutrophilic scarring alopecias.
METHODS: We performed a retrospective review comparing primary scarring alopecia (neutrophilic, n = 90; lymphocytic, n = 100) and non-scarring alopecia (n = 123) for presence of EDD, seen in Boston University School of Medicine between 2013 and 2017.
RESULTS: EDD was more commonly seen in primary neutrophilic scarring (62.2%, 56/90) and primary lymphocytic scarring alopecias (54.0%, 54/100) than in non-scarring alopecias (25.2%, 31/123) (P < 0.001). Albeit uncommon, non-scarring alopecias exhibited the biggest ratio of dilated eccrine duct lumen to background duct lumen (14.33), followed by lymphocytic (10.99) and neutrophilic scarring alopecias (6.66).
CONCLUSIONS: EDD is seen more frequently in primary scarring alopecias compared with non-scarring alopecias and usually found in sections containing inflammation and dermal fibrosis, serving as a possible histopathologic clue for a scarring process. Non-scarring alopecias have significantly fewer but considerably larger EDD which, may imply a different pathologic cause.