Hidrocystomas - A Brief Review

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

September 06, 2006

Differential Diagnosis

Eccrine hidrocystomas and apocrine hidrocystomas have a very similar presentation, and their distinction from other head and neck cyst-like lesions must ultimately be verified on biopsy and by careful examination under the microscope. For both types, cystic lesions such as epidermal inclusion cysts, mucoid cysts, hemangioma, and lymphangioma are considered in the differential. Attention is given to cysts (mostly apocrine hidrocystomas) that resemble basal cell carcinoma of the eyelid or malignant melanoma because of their color (typically blue-black). A biopsy of the lesions is very important to exclude these diagnoses.

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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

Differential Diagnosis

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