Syringoma
Introduction
Introduction to sweat duct tumor Syringoma is an adenoma of the small sweat gland duct in the epidermis. Histochemical studies have shown that the sweat duct tumor contains a phosphorylase and hydrolase derived from the typical small sweat gland. It is a benign tumor of sweat gland that differentiates into the terminal sweat duct. . Some patients have a family history, the lesions occur in the eyelids and cheeks, with hard and small pimples as the main performance, rarely self-resolving, but not malignant. Can not be treated. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: hair loss
Cause
Cause of sweat duct tumor
(1) Causes of the disease
The causes of the formation of sweat duct tumors are quite complex, including genetics, natural aging, female hormones, and personal physique.
1. Inherited with the disease This disease is a tumor-like tumor, sometimes with a family history.
2. May be related to endocrine disorders.
(two) pathogenesis
Histochemical studies have shown that sweat duct tumors contain phosphorylases and hydrolases of typical adipose gland origin. Many cystic ducts and some solid epidermal cell cords are visible in the upper and middle parts of the dermis, embedded in the fibrous matrix, and the cystic duct wall often Lined with two layers of cells, mostly flat, the inner cells are cavitation-like, and the outer wall cells of some catheters are convex and curved outwards, shaped like commas or sputum. In continuous sections, these cystic and epidermal catheters can be seen. The dilatation sac is connected, but not connected to the apocrine secretory segment below.
Prevention
Sweat tube tumor prevention
The cause of the formation of sweat duct tumors is quite complicated, including heredity, natural aging, female hormones, and personal physique. Therefore, no matter how skin care is done, the formation of sweat duct tumors cannot be prevented at all. In this case, then seek the correct one. It is absolutely important to treat, do not arbitrarily squeeze or use an unclean needle to try to pick it up, so as not to cause skin infection.
Complication
Sweat tube tumor complications Complications
This disease is a chronic disease course, and it will not subside itself for a lifetime. Some sweat duct tumors remain static for many years. When people have trauma, overwork, menstrual period or endocrine disorders and other human immunity, the rash can gradually increase or increase. Large or several fusion into a large nodular sweat duct tumor makes the treatment more difficult and the treatment time is longer.
Symptom
Sweat tube tumor symptoms common symptoms itchy itching pimples
In the upper part of the dermis, most of the tubes are embedded in the fibrous matrix. The catheter is lined with two layers of epithelial cells, which contain amorphous fragments, and some of the catheters have a small or epithelial cell cord to form a comma-like or scorpion-like appearance.
The disease occurs in women, puberty, multiple lesions found in the face, especially the eyelids, neck and chest, a small number of patients with rash, in addition to the face, chest, abdomen and limbs can have a wide range of symmetry rash, The rash is a skin color, pale yellow or brown flat papules, 1-3 mm in diameter, solid, can be clustered but not fused, generally no symptoms, and some patients have itching or burning sensation due to difficulty in sweating in summer.
1. Good hair parts: lower eyelids and cheeks, neck side, chest are also more common, also seen in the waist, back, limbs and genitals.
2. Clinical symptoms: skin color, pale yellow or brownish yellow, bulging plaque, round, oval or irregular, smooth surface or with greasy matter, waxy luster, clear border, no above Hair, also in the form of warts or papillary hyperplasia, hemispherical or flat papules, usually multiple, usually several millimeters in diameter, most dense and not fused, often symmetrically distributed in the lower eyelid, also visible in the forehead, cheeks and genitals, Chronic disease, rarely self-resolved, usually no symptoms, sometimes itching, and it can be itchy in females.
3. In addition, there are the following subtypes:
(1) clear cell syringoma (clear cell syringoma): often associated with diabetes, clinical epithelial lesions and squamous cell tumors, age, gender and skin lesion distribution is also no difference, in addition to histopathological findings, It is often associated with diabetes; of the 60 cases reported in the literature, only one case was not associated with diabetes, and rash lesions were also reported.
(2) Eruptive syringoma: The disease is first described by Darier. The disease is histologically the same as the eyelid bronchial tumor, but the lesion is rashy and symmetrically distributed in the neck, chest, and armpit. On the upper arm and umbilical cord, the skin lesions are glossy and light-spotted purplish rashes, similar to lichen planus and secondary syphilis. This sub-category is also reported to be associated with Down syndrome. It is familial and is also found in transparent cell tissue. Diabetic women, the disease can be clinically confused with Gougerot-carteaud reticular papillomatosis.
(3) Other variants: Individual cases of unusually common squamous cell carcinomas, including limited to the head, causing alopecia, unilateral linear or sputum-like distribution; limited to female genitals or penis; Limited to the distal limb; and lichen planus and chestnut-like phenotype.
Examine
Sweat tube tumor examination
Histopathological examination: There are many small catheters in the dermis. The wall is composed of two rows of epithelial cells, mostly flat, but the inner cells are even or vacuolated. The lumen of the catheter contains amorphous substances, and some of the catheters have small comma-like epithelium. The tail is scorpion-shaped, in addition to the basophilic epithelial cell bundle not associated with the catheter, adjacent to the epidermis, a cystic duct lumen is seen, the lumen is filled with keratin, and the cyst wall is lined with cells containing transparent keratin particles. In the puberty lesions, a large number of mature or nearly mature sebaceous glands are visible in the dermis, and there is no sebaceous gland duct, which is directly connected to the hair follicle funnel. The epidermis above it is sickle-like or papillary-like hyperplasia, and the lesions in infants and children are in children. Only a little or no sebaceous gland structure.
The common sweat duct tumors in transparent cell squamous cells are mixed with transparent ground glass-like material around the cell nest of small and dark oval-shaped nucleus. Immunohistochemical analysis of keratin expression proves that it is a metabolism of traditional smear tumor. Sexual subtype.
Diagnosis
Diagnosis and diagnosis of sweat duct tumor
diagnosis
According to the clinical characteristics, the disease is generally not difficult to diagnose, if necessary, biopsy pathological immunohistochemical examination to confirm the diagnosis.
Differential diagnosis
1. Xanthoma: common in the upper iliac crest, is a yellow papule or plaque, often symmetrically distributed, more common in middle-aged women, often accompanied by hyperlipoproteinemia.
2. Flat warts: mainly found in adolescents, mostly in the face, but the lower jaw is not a good hair part, in addition to the face, can also be seen in the back of the hand, for the surface is smooth, hard, pink, light yellow, light brown or normal skin color of sesame Flat papules of the size of soy beans, scattered or distributed in groups, generally asymptomatic, occasionally painful, can disappear on their own, histopathology can confirm the diagnosis.
3. : skin lesions can occur in any part of the body, pale yellow or brown-black scorpion-like papules, excessive keratosis, rough, mostly linear distribution, histopathological examination of epidermal hyperkeratosis, papillary tumor Hyperplasia, hypertrophy of the spinous layer, increased melanin in the basal layer, but no sputum cells.
4. Papillary sweat duct cystadenoma: more common in the scalp, lesions are a single papillary nodule, plaque, surface exudation, scarring, histopathological examination of the epidermis of different degrees of papillary hyperplasia, not Regularly invade the dermis to form a papillary sac.
5. Juvenile melanoma: The lesion is a single pink or reddish-brown solid nodule with a diameter of 1 to 2 cm. The surface is smooth or swelled, and it is easy to bleed after trauma.
6. Hard plaque basal cell epithelial tumor: the lesion is flat or slightly concave hardened yellowish plaque, smooth, shiny surface, often unclear edges, and completely different histopathology.
7. Hair follicle tumor: The skin lesion is multiple small round solid papules and small nodules. The face is more common, distributed to the center, and a few are single hair papules.
8. Hair epithelial tumor: occurs in the nasolabial fold, the papule is larger, tends to be hemispherical, is autosomal dominant, and histopathology can confirm the diagnosis.
9. Rash-like sweat duct tumor: It should be differentiated from papular ring granuloma and papular syphilis. The former biopsy showed progressive necrosis, the latter syphilis seropositive, and the rash can resolve spontaneously.
