Apocrine Hidrocystoma Clinical Presentation

  • Author: Jesse M Olmedo, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jul 22, 2011
 

History

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.

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Physical

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]

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.[4] 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).

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Causes

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

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Contributor Information and Disclosures
Author

Jesse M Olmedo, MD  Staff Physician, Department of Dermatology, Beatrice Keller Clinic

Disclosure: Nothing to disclose.

Coauthor(s)

Ronald P Rapini, MD  Josey Professor and Chair, Department of Dermatology, Professor of Pathology, University of Texas Medical School at Houston and MD Anderson Cancer Center

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

Disclosure: Elsevier publishers Royalty Independent contractor

Specialty Editor Board

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.

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, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD  Herman Beerman Associate 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 and American Society of Dermatopathology

Disclosure: Lippincott Williams Wilkins Royalty Textbook editor; DLA Piper Consulting fee Consulting

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous Chief Editor, William D. James, MD, to the development and writing of this article.

References

  1. Alessi E, Gianotti R, Coggi A. Multiple apocrine hidrocystomas of the eyelids. Br J Dermatol. Oct 1997;137(4):642-5. [Medline].

  2. Combemale P, Kanitakis J, Dupin N, Parraud C, Guigon M. Multiple Moll's gland cysts (apocrine hidrocystomas) of the eyelids. Dermatology. 1997;194(2):195-6. [Medline].

  3. de Eusebio E, Lopez-Bran E, Rojo S, Suarez R, Sanchez Yus E, Robledo A. Multiple hidrocystomas. Dermatology. 1996;193(2):152-3. [Medline].

  4. Ter Poorten HJ. Apocrine hidrocystoma of the right scapula. Arch Dermatol. Dec 1977;113(12):1730. [Medline].

  5. del Pozo J, Garcia-Silva J, Pena-Penabad C, Fonseca E. Multiple apocrine hidrocystomas: treatment with carbon dioxide laser vaporization. J Dermatolog Treat. Jun 2001;12(2):97-100. [Medline].

  6. Dailey RA, Saulny SM, Tower RN. Treatment of multiple apocrine hidrocystomas with trichloroacetic acid. Ophthal Plast Reconstr Surg. Mar 2005;21(2):148-50. [Medline].

  7. Woolery-Lloyd H, Rajpara V, Nijhawan RI. Treatment for multiple periorbital eccrine hidrocystomas: botulinum toxin A. J Drugs Dermatol. Jan 2009;8(1):71-3. [Medline].

  8. Hashimoto K, Lever WF. Tumors of skin appendages. In: Freedberg IM, Eisen AZ, Wolff K, eds. Fitzpatrick's Dermatology in General Medicine. Vol 1. McGraw-Hill Professional Publishing; 1999:899.

  9. Mackie RM. Tumors of skin appendages. In: Champion RH, Wilkinson DS, Ebling FJG, eds. Rook/Wilkinson/Ebling: Textbook of Dermatology. Vol 2. Blackwell Science Inc; 1998:1703-6.

 
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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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