Periorbital Syringoma: A Pilot Study of the Efficacy of Low-Voltage Electrocoagulation

BACKGROUND: Management of periorbital syringomas is problematic and avoided by many inexperienced physicians. The medical literature presently prefers CO(2) laser resurfacing to many other modalities, but the subject of electrosurgery has not been well explored. OBJECTIVES: To evaluate the clinical efficacy of electrocoagulation at low voltages in treating periorbital syringomas. MATERIALS AND METHODS: Twenty cases were collected during the period of 2002 through 2005. All cases were photographed before treatment with a dual-frequency 4-MHz radiofrequency device (Surgitron, Ellman International, Inc., Hewlett, NY) at a power of 1 to 2 in electrocoagulation mode. Six-week follow-up visits were scheduled to discuss occurrences and expectations, observe treatment effects, and apply further electrosurgery if needed. RESULTS: Clinical improvement increased with each subsequent treatment session. All patients scored either moderate or marked clinical improvement by their final visits, with 60% (11/18) revealing a marked clinical improvement (i.e., >70% clearance). The most common encountered adverse effects consisted of periorbital burning, swelling, redness, and pigmentary changes. CONCLUSION: Low-voltage electrocoagulation is an effective therapy for periorbital syringoma and should be considered when treating this difficult condition. To our knowledge, this is the first study utilizing electrocoagulation for removal of syringomas.