Hidrocystomas - A Brief Review

Introduction

Hidrocystomas -- rare, benign, cystic lesions of the skin -- can be either eccrine or apocrine, and are often found on the head and neck region.

Eccrine hidrocystomas are small and tense thin-walled cysts, ranging from 1 to 6 mm in diameter, and can occur as single or multiple lesions.^[1] They are found predominantly in adult females and are located mostly on the periorbital and malar regions.

Apocrine hidrocystomas arise from the proliferation of apocrine glands and are usually solitary, with a diameter of 3 to 15 mm.^[1] Apocrine lesions are also found mostly on the head and neck and along the eyelid margin near the inner canthus.^[2] Apocrine lesions are less likely than eccrine lesions to occur at periorbital regions; nevertheless, the general distribution of lesions tends to occur in similar locations on the body for apocrine and eccrine hidrocystomas.^[1]

Although rare and typically asymptomatic, eccrine and apocrine hidrocystomas are often of interest to physicians of different specialties. When encountered by practitioners, the approach to these lesions is facilitated by the clinical recognition of the subtypes and knowledge about their management. Furthermore, their close resemblance to certain, more serious skin disorders such as basal cell carcinomas necessitates an understanding of the histology of each type of hidrocystoma for the purposes of differential diagnosis. Hence, in this brief review we present a simplified approach to the diagnosis and management of both types of hidrocystomas.

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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