Hidrocystomas - A Brief Review

Khashayar Sarabi, BS, MSIV; Amor Khachemoune, MD, CWS

September 06, 2006

Case Report

A 69-year-old man presented to our office with a small, clear, cystic papule filled with watery fluid, which had been present for several months. The lesion was observed to be on his left upper eyelid and measured approximately 4 mm x 3 mm (Figure). The patient denied any diplopia, vision loss, or any other lesions on his face or body. His review of systems, personal and family histories were all normal or noncontributory. After diagnosing solitary eccrine hidrocystoma on the basis of the clinical evidence, we discussed Treatment options with our patient, including puncture and drainage of the lesion and surgical excision. The patient opted to return for follow-up observation for the time being, but agreed to consider further intervention should the lesion become symptomatic or more noticeable.

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Cite this: Hidrocystomas - A Brief Review - Medscape - Sep 05, 2006.

Table. Differentiation Between Eccrine and Apocrine Hidrocystomas
	Eccrine Hidrocystomas	Apocrine Hidrocystomas
No. of lesions	Solitary or multiple	Primarily solitary (but occasionally manifesting as multiple lesions)
Color	Ranges from flesh-colored to light-blue tint	Ranges from dark-blue tint to black
Size	1 to 6 mm in diameter	3 to 15 mm in diameter
Age group affected	30-75 years	30-75 years
Gender distribution	More prevalent among females than among males	Females and males are affected in equal numbers
Epithelium types	1-2 layers of cuboidal epithelium	Single/double cuboidal-columnar epithelium
Stains	S-100 positive (solitary type), PAS negative	S-100 negative, PAS positive
Special cellular features	No decapitation of cells, no secretory cells	Decapitation of secretory cells, papillary projections seen under microscope
Body location	Malar, periorbital, chest, axilla, neck	Face, ears, head, chest, shoulders
Possible treatments	Puncture and drainage, electrodessication, carbon dioxide laser, anticholinergic topical creams; placement in cold temperature	Puncture and drainage, electrodessication, carbon dioxide laser, anticholinergic topical creams
Special features	Worse in hot, humid weather	No change with temperature

PAS = periodic acid-Schiff

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Hidrocystomas - A Brief Review

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