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汗管瘤:244例临床病理研究

Syringoma: A clinicopathological study of 244 cases.

作者信息

Ciarloni L, Frouin E, Bodin F, Cribier B

机构信息

Clinique dermatologique, faculté de médecine, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.

Service d'anatomie et de cytologie pathologiques, hôpital Jean-Bernard, 2, rue de la Milétrie, 86021 Poitiers cedex, France.

出版信息

Ann Dermatol Venereol. 2016 Aug-Sep;143(8-9):521-8. doi: 10.1016/j.annder.2015.06.025. Epub 2016 Apr 21.

Abstract

BACKGROUND

Syringomas are benign tumours of the sweat glands, the most familiar clinical presentation of which is the presence of multiple lesions on the eyelids. The aim of our study was to determine the clinical and histological characteristics of a large series of patients and to examine anatomoclinical correlations.

PATIENTS AND METHODS

This was a retrospective study conducted in all of the cases of syringoma analysed at the cutaneous histopathology laboratory in Strasbourg between 1970 and 2008. The clinical elements, patient history and diagnostic data were collated. All slides were re-read in order to determine the microscopic characteristics of the lesions.

RESULTS

Two hundred and forty-four lesions were included. The sex ratio was 0.27 and the mean age was 42 years (8 to 85 years). Multiple syringomas were noted in 76% of cases, of which 29.2% were eruptive, and one case occurred in a setting of metastatic melanoma. The sites of predilection were the face (56.7%, of which 36.3% on the eyelids), the chest (18.1%) and the neck (17.5%) for the multiple forms. The lesions were in the form of papules (67%), either brown (34.2%) or flesh-coloured (19.8%). Pruritus was reported in 14 cases, including 4 at vulvar sites (out of a total of 8). A diagnosis of syringoma was made by the clinician in only 30.2% of the multiple forms, with mastocytosis being proposed in 7.1% of cases. The clear-cell forms (18 cases) presented no special clinical features.

CONCLUSION

Syringomas are frequently multiple and are seen mainly in women. They are found predominantly on the face and trunk, and lesions are generally brown and pruritic, a little-known feature that accounts for the degree of diagnostic confusion with mastocytosis. The vulvar forms, which are often pruritic, are poorly known. The eruptive forms may include a hormonal component.

摘要

背景

汗管瘤是汗腺的良性肿瘤,其最常见的临床表现是眼睑出现多发性损害。我们研究的目的是确定一大组患者的临床和组织学特征,并研究解剖临床相关性。

患者与方法

这是一项回顾性研究,纳入了1970年至2008年间在斯特拉斯堡皮肤组织病理学实验室分析的所有汗管瘤病例。整理了临床资料、患者病史和诊断数据。所有切片均重新阅片以确定病变的微观特征。

结果

纳入244个损害。男女比例为0.27,平均年龄为42岁(8至85岁)。76%的病例为多发性汗管瘤,其中29.2%为发疹性,1例发生于转移性黑素瘤背景下。多发性损害的好发部位为面部(56.7%,其中36.3%位于眼睑)、胸部(18.1%)和颈部(17.5%)。损害表现为丘疹(67%),颜色为棕色(34.2%)或肤色(19.8%)。14例报告有瘙痒,其中4例位于外阴部位(总共8例外阴部位损害)。临床医生仅对30.2%的多发性损害诊断为汗管瘤,7.1%的病例拟诊为肥大细胞增多症。透明细胞型(18例)无特殊临床特征。

结论

汗管瘤常为多发性,主要见于女性。主要位于面部和躯干,损害一般为棕色且伴有瘙痒,这一鲜为人知的特征导致与肥大细胞增多症的诊断混淆。外阴型汗管瘤常伴有瘙痒,鲜为人知。发疹性汗管瘤可能有激素成分。

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