Women with syringoma were more likely to have elevated serum progesterone than women without the condition, with high progesterone detected in 29% of patients with syringoma compared with 6% of controls. The researchers' noted that the findings suggested a possible hormonal association.
The single-center observational study included 70 women examined at the Padang Bulan Public Health Center in Medan, Indonesia, from October 2023 to August 2024, including 35 patients with syringoma and 35 controls. Participants were aged 18 years or older and had regular menstrual cycles. Women who were pregnant, breastfeeding, menopausal, using hormonal contraceptives, or taking prescribed medications within the prior 3 months were excluded. The researchers enrolled only women to reduce hormonal heterogeneity.
The relationship between serum progesterone levels and syringoma was assessed as the primary outcome. Blood samples were collected during the luteal phase, and progesterone was measured using an enzyme-linked immunosorbent assay. Levels of at least 22 ng/mL were classified as high. Syringoma was diagnosed using clinical and dermoscopic examination, with histopathologic confirmation reserved for clinically atypical or uncertain cases.
High serum progesterone was detected in 10 of 35 patients with syringoma (29%) compared with 2 of 35 controls (6%). Patients with syringoma had 6.6 times the odds of high serum progesterone compared with controls.
Nearly half of patients with syringoma were aged 26 to 35 years. Localized syringoma was the most common form, occurring in 18 patients (51%), followed by familial syringoma in 9 (26%) and generalized syringoma in 8 (23%).
Syringoma most frequently affected the periorbital region. The inferior palpebral region was affected in 33 patients, followed by the orbital region in 22 and the infraorbital region in 10. Patients could have lesions in more than 1 location.
The researchers noted that the association between syringoma and progesterone levels suggested that the hormone may play a role in syringoma development through mechanisms affecting sweat gland activity and structure. They also noted that the findings were consistent with previous research reporting progesterone receptor expression in syringoma cells.
The study's single-center, cross-sectional design and relatively small sample limited causal inference and may have reduced statistical power. Although participants had regular menstrual cycles, blood sampling was not consistently timed to a specific cycle day. Diagnosis was based on clinical and dermoscopic criteria without routine histopathologic confirmation. The researchers also did not adjust for potential confounders, including age, menstrual phase, family history, body mass index, and other hormonal factors, in multivariable analyses.
The findings suggested an association between elevated serum progesterone and syringoma in the women studied but did not establish a causal relationship. Further prospective research is needed to determine whether progesterone has a role in the development of the condition.
“Larger prospective studies with standardized sampling timing, histopathologic confirmation, multivariable adjustment for confounders, and exploration of progesterone receptor expression (IHC) are needed to confirm causality and elucidate mechanisms,” wrote lead study author Ifen Ayu Malinda, of the Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sumatera Utara, and colleagues.
The authors reported no conflicts of interest.
Source: Frontiers in Medicine
