Hidrocystomas - A Brief Review

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

September 06, 2006

Management

The most common approach to the treatment of hidrocystomas (eccrine and apocrine) is simple needle puncture. However, in the Robinson type, a simple needle puncture will not produce lasting improvement. Multiple-type lesions have been successfully treated with topical 1% atropine or scopolamine creams, although anticholinergic side effects could cause patients to discontinue the treatment.^[10] Excision of hidrocystomas can lead to scars, and treatment involving incisions and drainage can lead to recurrence after 6 weeks; this can be overcome by cauterization and electrodessication of the cyst wall.^[1]

Gupta and colleagues^[4] reported the use of electrodessication to be successful in the treatment of multiple apocrine tumors of less than 1 cm in diameter. Other methods that have shown success have been carbon dioxide laser vaporization and laser treatment.^[4] Tanzi and colleagues^[11] effectively treated a patient with pulsed-dye treatment with a 585-nm laser, and no recurrence was observed after 18 months of treatment. Finally, avoiding hot temperatures or humid conditions will help prevent worsening of symptoms in patients diagnosed with eccrine-type hidrocystomas.

References

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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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