Temporary tattooing followed by Q-switched alexandrite laser for treatmentof syringomas

BACKGROUND. Syringomas usually develop in women as multiple skin-colored pa pules primarily seen on the periocular regions and cheeks. They can cause c osmetic problems and lead to poor self-esteem. Though several treatment mod alities have been established, such as excision, electro/cryosurgery, chemi cal peeling, and CO2 laser surgery, none of them are satisfactory due to th eir limitations and side effects, for example, pain, prolonged healing time , postoperative erythema/pigmentary changes, and scarring. OBJECTIVE. The objective of this study was to develop a new treatment metho d for syringoma and to minimize the side effects through selective destruct ion of the tumor. METHODS. Six patients with multiple periorbital syringomas were enrolled in this study. The surface epithelium of the syringomas was vaporized by CO2 laser, and black ink was introduced in order to allow penetration to the de rmis using iontophoresis, Subsequently the artificial tattoos were removed by Q-switched alexandrite laser. The results were evaluated clinically by b oth physicians and patients at 1, 2, 4, and 8 weeks after treatment, RESULTS. The majority of syringoma in the six patients disappeared by the f irst follow-up 1 week after treatment. There were no cases of prolonged ery thema persisting beyond 2 weeks. Additional treatment was repeated in the s ame manner in order to remove the remaining syringomas in one patient. Ther e were no recurrences during the 8-week follow-up period. CONCLUSION. Our new treatment was safer, less painful, nonscarring, and the re was a quicker recovery period and less of a burden to repeat treatment w hen necessary.