YAG laser and botulinum toxin A combo effective treatment option of syringoma

Syringoma, also called syringadenoma, is a common tumor derived from intraepidermal eccrine ducts1 and is typically present in early adulthood, with a female predominance. Syringoma includes four variants: localized, familial, a form originating from the eccrine sweat duct associated with Down syndrome (DS), and a generalized variant, including multiple and eruptive syringoma.1 Localized syringoma is the most common type but has the mildest symptoms. Typical localized syringoma behaves as follows: scattered, multiple, or dense symmetrical distributed in the eyelid and the upper cheek, normal skin color or light brown color, medium-textured flat papules or hemispherical papules, a diameter from 1 mm to 3 mm, and a firm, waxy luster on the surface, often causing cosmetic question.

Syringoma is a common but refractory benign skin tumor. Conventional treatment, such as ultra-pulsed carbon dioxide (CO2) laser or cryotherapy, often requires multiple treatment and can easily cause prolonged erythema, scarring, or depression, which are frustrating, so there is an urgent need to seek a safer and more effective method. In this article, we tried to demonstrate the Er:YAG laser combined with botulinum toxin A (BTXA) as a safer and more efficacious method for treating syringomas.

Twenty-one patients with local syringomas were treated with erbium laser ablation. Immediately after laser treatment, approximately 10 units of BTXA were sprayed on the wound for 10 min.

Result:

In total, 21 patients underwent 1.62 ± 0.74 treatments; their Periorbital Syringoma Severity Index (PSSI) score declined from 4.19 (before treatment) to 1.10 (after treatment), and the number of treatments was significantly lower than those reported in previous literature using the erbium laser alone.

The Er:YAG laser combined with botulinum toxin A for the treatment of syringoma is a safer and more effective treatment than traditional treatment methods.

Reference:

Yao, B, Chen, W, Wu, S, Gu, Q, Feng, W. Er:YAG laser combined with botulinum toxin A for patients with local syringomas: A preliminary report. J Cosmet Dermatol. 2023; 00: 1- 8. doi:10.1111/jocd.15800