PMC9282696_01
Bilateral vulvar syringomas with lichenification
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F1
On detailed examination, there were multiple skin colored, smooth, mostly flat-topped, and a few dome-shaped, soft papules ranging from 1-5 millimeters in size, predominantly over the forehead, eyelids, cheeks, and sparsely over the upper lip and chin [Figure 1].
Facial syringomas involving the forehead, cheeks, and periorbital area
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F2
Examination of genitalia revealed lichenification and hyperpigmentation of labia majora with multiple discrete and few confluent smooth, flat-topped papules [Figure 2], and similar to facial lesions.
Histopathology (vulva): Showing multiple ductal structures with tadpole appearance (arrow) in the fibrous stroma (H and E, x100)
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F3
The characteristic tadpole-like appearance was noticed [Figures 3 and 4].
Histopathology (face): Showing multiple dilated ductal structures with amorphous debris (H and E, x100)
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F4
The characteristic tadpole-like appearance was noticed [Figures 3 and 4].