Hidrocystomas - A Brief Review

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

Disclosures

September 06, 2006

Clinical Presentation

Eccrine hidrocystomas are benign tumors of sweat gland origin and are classified into 2 major groups: the Smith type, which is the most prevalent solitary type, and the Robinson, or multiple, type. They are typically dome-shaped, have an amber, brown, or bluish tint, and range from 1 to 6 mm in diameter. During hot or humid weather, these lesions will grow in size and/or multiply in number. Eccrine hidrocystomas usually do not involve the eyelid margin but rather are distributed around the eyelid skin; this, along with a lighter color presentation, typically differentiates it from the apocrine type.[1]

The clinical presentation of apocrine hidrocystomas is very similar to that described above. They appear as dome-shaped, solitary, clear, cystic nodules with a smooth surface, and the color varies, ranging from flesh-colored to blue-black. Although the solitary hidrocystoma is the most common clinical presentation, multiple lesions on the face and neck have been reported.[5] The cysts tend to stay asymptomatic and will follow a gradual course until a certain size is reached. There is no evidence of seasonal variations associated with apocrine hidrocystoma, whereas patients tend to present with eccrine hidrocystomas mostly during hot, humid weather.[6] The Table  delineates the distinctions between the 2 types of hidrocystomas, as well as the similarities.

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