[Psoriasis at the site of healed herpes zoster: Wolf's isotopic response].

F Allegue,a C Fachal,b M Romo,c MI Lopez-Miragaya,d and S Perezd Secciones de aDermatologia, bAnatomia Patologica, cHematologia, and dMicrobiologia, Hospital do Meixoeiro-CHUVI, Vigo, Pontevedra, Spain These tumors show a normal analytical profile, although 1 incidental case with elevated carcinoembryonic antigen has been published.7 Pathology studies have shown an epithelial growth in the upper half of the reticular dermis consisting of cells with a pale eosinophilic cytoplasm arranged in nests or tubules and surrounded by a sclerotic stroma. The tubular areas contain basophilic granular cells and ductal differentiation with central lumens lined with a compact eosinophilic cuticle. Epithelial growths in the form of a “tadpole’s tail” or “comma” is characteristic.8 The variant known as clear-cell syringoma is more common among diabetics and is characterized by glycogen-laden cells. Immunohistochemical studies of this tumor show positivity for EKH-6, which would support the eccrine ductal origin. The description of eczematous lesions that leave eruptive syringomas as sequelae would raise the hypothesis that the classic eruptive form is actually a reactive hyperplasia against inflammatory processes in the sweat gland ducts.9 The histological differential diagnosis should be done with milia, microcystic adnexal carcinoma, and desmoplastic trichoepithelioma. These tumors may benefit from physical treatments such as superficial cryotherapy, fulguration, and electrodesiccation, or from chemical agents such as isotretinoin, tretinoin, adapalene, or a 1% aqueous topical solution of atropine. At present, the best treatment is considered to be ablation with ultrapulsed CO2 laser and preliminary treatment with trichloroacetic acid to minimize scarring.10 None of these treatments are considered satisfactory or prevent recurrences. Because of the age at onset, the fact that the condition did not always appear in outbreaks, and that it affected various skin areas, including the eyelid, we considered our patient to present a form of multifocal generalized syringomas that started on the eyelid.