Introduction
Background
Apocrine hidrocystomas are benign cystic proliferations of the apocrine secretory glands. Apocrine hidrocystomas most commonly appear as solitary, soft, dome-shaped, translucent papules or nodules and most frequently are located on the eyelids, especially the inner canthus. Apocrine hidrocystomas grow slowly and usually persist indefinitely.
Pathophysiology
The exact stimulus for the development of an apocrine hidrocystoma is unknown. Plausible causes of the closely related eccrine hidrocystoma include occlusion or blockage of the sweat duct apparatus, which results in the retention of sweat and a dilated cystic structure.
Frequency
United States
Apocrine hidrocystomas are relatively common in the United States.
Mortality/Morbidity
Apocrine hidrocystomas are entirely benign and seldom recur after removal. Cysts may annoy patients; however, symptoms usually are mild or absent. Vision usually is not affected.
Race
No predilection for race or geographic region is recognized for apocrine hidrocystomas.
Sex
No sex predilection is described for apocrine hidrocystomas.
Age
Apocrine hidrocystomas occur in adulthood, although in no particular age group.
Clinical
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.
Physical
- Apocrine hidrocystomas usually occur as solitary translucent papules or nodules.
- Apocrine hidrocystomas often appear tense and shiny. The coloration varies from flesh-colored to blue or black (see Media File 1).
- 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.
- Cysts are mobile with palpation and transilluminate.
- 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.
- Apocrine hidrocystomas are not affected by variation in temperature (unlike eccrine hidrocystomas).
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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References
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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].
de Eusebio E, Lopez-Bran E, Rojo S, Suarez R, Sanchez Yus E, Robledo A. Multiple hidrocystomas. Dermatology. 1996;193(2):152-3. [Medline].
Ter Poorten HJ. Apocrine hidrocystoma of the right scapula. Arch Dermatol. Dec 1977;113(12):1730. [Medline].
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].
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].
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].
Bures FA, Kotynek J. Differentiating between apocrine and eccrine hidrocystoma. Cutis. Jun 1982;29(6):616, 619-20. [Medline].
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.
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.
Milum EA. A solitary pigmented tumor of the face. Apocrine hidrocystoma. Arch Dermatol. Apr 1991;127(4):572, 575. [Medline].
Schleicher SM. Multiple translucent facial papules. Apocrine hidrocystoma. Arch Dermatol. Dec 1998;134(12):1627-8, 1630-1. [Medline].
Shields JA, Eagle RC Jr, Shields CL, de Potter P, Markowitz G. Apocrine hidrocystoma of the eyelid. Arch Ophthalmol. Jun 1993;111(6):866-7. [Medline].
Smith JD, Chernosky ME. Apocrine hidrocystoma (cystademnoma). Arch Dermatol. May 1974;109(5):700-2. [Medline].
Further Reading
Keywords
apocrine hidrocystoma, apocrine hidrocystomas, apocrine cystadenoma, apocrine retention cyst, benign cystic proliferation, benign cyst


Overview: Apocrine Hidrocystoma