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    J Cutan Pathol. 2009 Dec;36(12):1312-5. Epub 2009 Jun 11.

    Autoimmune acrosyringitis with ductal cysts: reclassification of case of eruptive syringoma.

    Chandler WM, Bosenberg MW.

    Pathology, University of Utah Health Sciences, Department of Pathology, Division of Anatomic Pathology, Huntsman Cancer Hospital, Room 3860, Salt Lake City, Utah 84112, USA. Wells.chandler@hsc.utah.edu

    Syringomas are architecturally complex tumors composed of small, cystically dilated segments of dermal eccrine duct. Syringomas typically form isolated flesh-colored periorbital papules, however, in a peculiar condition termed eruptive syringoma; scores develop simultaneously in near confluence over a large surface area. While traditionally regarded as a neoplasm, more recent observations indicate eruptive syringoma is a reactive proliferation secondary to autoimmune disruption of the acrosyringium. We present the case of a 44-year-old woman with eruptive syringoma of the labia majora and prominent lymphocytic inflammation in the acrosyringium. Immunohistochemical stains confirm that the infiltrate is composed of CD4+ and CD8+ T cells, without significant CD20 B cells or CD138 plasma cells. Sequential sections of the syringoma reveal a complex 3-dimensional architecture with functionally isolated cysts, not connected to adjacent cysts or ducts by a discernable epithelium. These findings support the conclusion that eruptive syringoma is a tortuous proliferation of dermal eccrine ducts and fibrous stroma secondary to autoimmune destruction of the acrosyringium. Conceptually, the disorganized expansion of an eccrine duct syringoma may be analogous to a peripheral nerve traumatic neuroma.

    PMID: 19522848 [PubMed - in process]

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