Response of multiple syringomas to isotretinoin

Two female patients with multiple syringomas were treated for 5/6 months with cumulative doses of 9 and 11 g isotretinoin respectively. Clinically, the appearance of the lesions in both patients improved from the third month on. After therapy, the lesions were flattened, softened, and skin coloured. Histologically, a marked reduction of size and numbers of syringomas was observed, and the contents of cystic lesions seemed reduced 6 months after therapy. Ultrastructurally, changes in the cystic and ductal epithelium correspond with the keratin modulating efficacy of the drug, but also point at a drug-induced change in intracellular lipid composition.