Treatment of syringoma using an ablative 10,600-nm carbon dioxide fractional laser: a prospective analysis of 35 patients.
Treatment of syringoma aims to destroy the dermal tumor using methods that can include surgical excision, electrodessication, cryosurgery, chemical peeling, and laser ablation, but complete removal of syringomas is often unsuccessful, and recurrence occurs frequently. To investigate the therapeutic efficacy of an ablative 10,600-nm carbon dioxide fractional laser system (CO(2) FS) for the treatment of periorbital syringomas. Thirty-five patients with periorbital syringomas were treated with two sessions of CO(2) FS at 1-month intervals. Laser fluences were delivered in two or three passes over the lower eyelids, using a pulse energy of 100 mJ and a density of 100 spots/cm(2) . Clinical improvement was assessed by comparing pre- and post-treatment clinical photographs and patient satisfaction rates. We examined the histological features of human periorbital syringomas treated with CO(2) FS. Evaluation of clinical results 2 months after treatment showed that 15 of the 35 patients (42.9%) demonstrated marked (51-75%) clinical improvement, 12 (34.3%) had moderate (26-50%) clinical improvement, five (14.3%) showed minimal (0-25%) improvement, and three (8.6%) showed near total (≥75%) improvement. Clinical improvement scores were less 4 months after the second CO(2) FS treatment (not statistically significant). The mean maximal depth of the necrotic column was 1,236.3 μm. A specimen obtained from the infraorbital area immediately after treatment showed formation of necrotic columns on the interfollicular skin. The use of CO(2) FS can have a positive therapeutic effect on periorbital syringomas. © 2011 by the American Society for Dermatologic Surgery, Inc.