Apocrine Hidrocystoma Clinical Presentation

Updated: Jan 26, 2017
  • Author: Jesse M Olmedo, MD; Chief Editor: William D James, MD  more...
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Presentation

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 Examination

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).

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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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