eMedicine Specialties > Dermatology > Benign Neoplasms

Apocrine Hidrocystoma

Author: Jesse M Olmedo, MD, Staff Physician, Department of Dermatology, Beatrice Keller Clinic
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
Contributor Information and Disclosures

Updated: Sep 25, 2009

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.
    • 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 Media File 1).
Clinical example of apocrine hidrocystoma.

Clinical example of apocrine hidrocystoma.

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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.
  • 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.

More on Apocrine Hidrocystoma

Overview: Apocrine Hidrocystoma
Differential Diagnoses & Workup: Apocrine Hidrocystoma
Treatment & Medication: Apocrine Hidrocystoma
Follow-up: Apocrine Hidrocystoma
Multimedia: Apocrine Hidrocystoma
References
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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. Bures FA, Kotynek J. Differentiating between apocrine and eccrine hidrocystoma. Cutis. Jun 1982;29(6):616, 619-20. [Medline].

  9. 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.

  10. 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.

  11. Milum EA. A solitary pigmented tumor of the face. Apocrine hidrocystoma. Arch Dermatol. Apr 1991;127(4):572, 575. [Medline].

  12. Schleicher SM. Multiple translucent facial papules. Apocrine hidrocystoma. Arch Dermatol. Dec 1998;134(12):1627-8, 1630-1. [Medline].

  13. 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].

  14. Smith JD, Chernosky ME. Apocrine hidrocystoma (cystademnoma). Arch Dermatol. May 1974;109(5):700-2. [Medline].

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Further Reading

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Keywords

apocrine hidrocystoma, apocrine hidrocystomas, apocrine cystadenoma, apocrine retention cyst, benign cystic proliferation, benign cyst

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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, Southern Medical Association, and Texas Medical Association
Disclosure: Elsevier publishers Royalty Independent contractor

Medical Editor

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.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University 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.

Managing Editor

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: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine 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, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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