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Case Reports

Abstract

Syringomas are benign neoplasms arising from eccrine glands; eruptive syringomas (ES) represent a more generalized form. ES primarily affects women, with onset in adolescence frequently on the chest, abdomen, axilla, or genitalia. Here, we present a case of a 55-year-old Spanish-speaking female with fibromyalgia who presented with a multi-year history of numerous non-pruritic reddish-brown macules and papules on bilateral forearms. Punch biopsy revealed dermal based epithelial cells with ductal differentiation and occasional basaloid cells forming cords and a tadpole growth pattern. Blood work returned significant for an A1C of 6.2. This presentation of ES was atypical given the patient’s advanced age and distribution on the bilateral forearms. There are limited reports of forearm ES in the literature, typically presenting with a delayed age of onset, like our patient, and often accompanied by acral lesions. Several of these cases reported co-occurrence with contact dermatitis, hyperkeratotic eczema, carcinoid tumor, photosensitivity, or displayed other eczematous changes on histology. Interestingly, our patient also described an episode of “psoriasis” with onset and resolution following initial presentation of ES. Prior researchers have suggested that inflammation may play a role in the pathogenesis of ES. Through this case, we aim to highlight a unique presentation of ES on the forearms, and add to the discussion on the relationship between inflammatory dermatoses and ES.