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Apocrine Hidrocystoma Clinical Presentation

  • Author: Jesse M Olmedo, MD; Chief Editor: William D James, MD  more...
Updated: Oct 07, 2015


Apocrine hidrocystomas usually are asymptomatic. No seasonal variation or familial tendencies have been identified. Apocrine hidrocystomas tend to appear during adulthood, grow slowly, and persist indefinitely.



Apocrine hidrocystomas usually occur as solitary translucent papules or nodules. Consistency is fluctuant and cystic. Size varies from a few millimeters to approximately 1.5 cm. Tumors occasionally manifest as multiple lesions, especially when of the eccrine hidrocystoma type.[1, 2, 3, 4, 5]

Apocrine hidrocystomas often appear tense and shiny. The coloration varies from flesh-colored to blue or black (see image below).

Clinical example of apocrine hidrocystoma. Clinical example of apocrine hidrocystoma.

Tumors have a predilection for the eyelid, particularly the inner canthus. Tumors may arise on other areas of the head, neck, and trunk.[6] Tumors also have been reported to occur on the penis, in the axillae, and in the anal region.

Lesion edges are not well delineated but blend gradually into adjacent skin. Walls, although translucent, are sufficiently thick that they seldom rupture spontaneously.

When incised, apocrine hidrocystomas collapse, and a thin, clear, brownish, or blackish fluid is released. The fluid color of an apocrine hidrocystoma does not result from the presence of melanin or hemosiderin but may result either from the Tyndall phenomenon or the presence of lipofuscin pigment.

Cysts are mobile with palpation and transilluminate.

Apocrine hidrocystomas are not affected by variation in temperature (unlike eccrine hidrocystomas).



Although the origin of apocrine hidrocystomas is not known entirely, they are believed to be adenomatous cystic proliferations of the apocrine glands.

Contributor Information and Disclosures

Jesse M Olmedo, MD 

Disclosure: Nothing to disclose.


Ronald P Rapini, MD Professor and Chair, Department of Dermatology, The University of Texas MD Anderson Cancer Center; Distinguished Chernosky Professor and Chair of Dermatology, Professor of Pathology, University of Texas McGovern Medical School at Houston

Ronald P Rapini, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Society for Investigative Dermatology, Texas Medical Association

Disclosure: Received royalty from Elsevier publishers for independent contractor; May receive consulting fee from FDA panel for consulting in future, since I am on one of their committees, but at this time so far have received zero from FDA.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Carrie L Kovarik, MD Assistant Professor of Dermatology, Dermatopathology, and Infectious Diseases, University of Pennsylvania School of Medicine

Carrie L Kovarik, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

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Clinical example of apocrine hidrocystoma.
Histology of apocrine hidrocystoma. Cystic spaces appear empty because sweat is removed during processing. Decapitation secretion often is seen in the lining.
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