A Man With Multiple Monomorphic Papules Appearing At Puberty: Case Report (Preprint)

BACKGROUND Familial eruptive syringomas (FES) are rare benign adnexal tumors of eccrine origin, typically presenting in females with papules on the anterior body surface. Atypical presentations may delay diagnosis and contribute to psychosocial burden. OBJECTIVE To describe an uncommon case of FES in a male patient with an atypical distribution and to review the diagnostic and therapeutic implications. METHODS We evaluated a 35-year-old male with a history of progressive, asymptomatic papules beginning in childhood. Clinical examination, family history, and histopathology were reviewed. A literature search was conducted to compare this case with previously reported presentations of FES. RESULTS Histopathology confirmed eruptive syringomas. The patient’s cousin had similar lesions, supporting familial inheritance. The distribution, with truncal and extremity involvement preceding facial lesions, differed from the classic anterior body pattern. Management was deferred given cosmetic concerns, the patient’s darker skin tone, and risk of post-inflammatory hyperpigmentation. CONCLUSIONS This case highlights the clinical variability of FES, the importance of early recognition to avoid misdiagnosis, and the need for cautious treatment planning in skin of color patients.