ABSTRACT
Apocrine hidrocystoma is a benign, cystic proliferation of the apocrine sweat gland that may present commonly on sun-exposed areas of the head and neck. However, given its location and features, apocrine hidrocystomas may often be confused with malignant tumors such as basal cell carcinomas or primary cutaneous mucinous carcinomas. Herein, we present an unusual case of an apocrine hidrocystoma presenting in the postauricular region and highlight the importance of histopathological examination of cystic tumors on the periauricular area.
Subject(s)
Head and Neck Neoplasms/pathology , Hidrocystoma/pathology , Sweat Gland Neoplasms/pathology , Adenocarcinoma, Mucinous/diagnosis , Carcinoma, Basal Cell/diagnosis , Diagnosis, Differential , Epidermal Cyst/diagnosis , Female , Head and Neck Neoplasms/therapy , Hidrocystoma/therapy , Humans , Middle Aged , Skin Neoplasms/diagnosis , Sweat Gland Neoplasms/therapyABSTRACT
INTRODUCTION: Although various treatment options for hidrocystomas have been described, the comparative efficacy of these treatments is poorly understood. METHODS: We conducted a systematic review of all articles describing the treatment of hidrocystomas. Treatment modalities were categorized as destructive surgical procedures, skin-directed therapies, systemic medical therapies, general measures, or combined. Patient and tumor characteristics, as well as response rate, recurrence rate, and adverse effects, were extracted from each article. RESULTS: A total of 94 articles involving 192 patients and 255 unique treatment events were included in the final analysis. Destructive surgical procedures had an overall response rate and recurrence rate of 92.9% and 10.8%, respectively. Skin-directed therapies had an overall response rate of 72.6%. The overall response rate to systemic medical therapies was 71.4%. Solitary hidrocystomas were primarily treated with destructive surgical procedures, including excision, which was associated with a 4.7% recurrence rate. Multiple hidrocystomas were successfully treated with a variety of therapies, including destructive surgical procedures and skin-directed therapies requiring ongoing or repeated therapy. CONCLUSIONS: Excision has the highest efficacy for solitary hidrocystomas. A number of therapies have shown efficacy for multiple hidrocystomas, including lasers, intracystic trichloroacetic acid, intracystic hypertonic glucose, topical and oral anticholinergics, and botulinum toxin. Aluminum chloride is associated with a low response rate. Larger comparative studies are needed to further evaluate the optimal treatments for solitary and multiple hidrocystomas.
Subject(s)
Hidrocystoma/therapy , Sweat Gland Neoplasms/therapy , HumansABSTRACT
Eccrine hidrocystomes (EH) are benign cystic tumors of dermal eccrine ducts. There is still no gold standard treatment option for EH because of the large number of lesions, the risk of cicatrization and the different treatment options offered. We offer combined oral isotretinoin and following erbium-yttrium aluminum garnet laser treatment as an alternative treatment option in difficult patients with EH.
Subject(s)
Dermatologic Agents/therapeutic use , Hidrocystoma/therapy , Isotretinoin/therapeutic use , Combined Modality Therapy , Hidrocystoma/drug therapy , Hidrocystoma/radiotherapy , Humans , Lasers, Solid-State , Low-Level Light Therapy , Male , Middle AgedABSTRACT
Multiple eccrine hidrocystomas are benign cystic skin lesions which originate from the sweat gland ducts and typically affect women's midfacial area. Sweating may lead to an increase in size of the translucent papules. In some cases hidrocystomas are associated with other diseases such as Parkinson's disease. Treatment options include laser, topical and systemic anticholinergic drugs (glycopyrrolate, clonidine, atropine, and oxybutynin), whereby therapeutic success is limited in most cases.
Subject(s)
Hidrocystoma/pathology , Hidrocystoma/therapy , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/therapy , Sweat Gland Neoplasms/pathology , Sweat Gland Neoplasms/therapy , Diagnosis, Differential , Humans , Male , Middle AgedABSTRACT
Eccrine hidrocystomas (EHs) are benign cystic lesions of the eccrine ducts. They may have a chronic course and seasonal variation, and have a female predilection. Solitary EH can be easily treated by surgical excision, whereas multiple lesions are difficult to treat. We report a 65-year-old woman with sarcoidosis and multiple EHs, who was treated with cryotherapy, which resulted in a reduction in lesion number of > 90%. To our knowledge, this is the first report of cryotherapy used for EH treatment. If this case is confirmed by further studies, cryotherapy may be a viable treatment option for EH.
Subject(s)
Cryotherapy , Hidrocystoma/therapy , Sarcoidosis/complications , Sweat Gland Neoplasms/therapy , Aged , Female , Humans , Treatment OutcomeABSTRACT
Giant, multi-loculated hidrocystomas represent a rare variant of the common, benign hidrocystoma. Hidrocystomas are generally 1-3 mm and rarely exceed 10 mm. We describe a case of giant multi-loculated hidrocystomas 1-2 cm in size that were located near both upper and lower eyelids. Multiple modalities have been used to treat hidrocystomas, including excision, pulsed-dye laser, electrodesiccation, curettage, tricholoracetic acid, botulinum toxin, and anticholinergics.
Subject(s)
Eyelid Neoplasms/diagnosis , Hidrocystoma/diagnosis , Sweat Gland Neoplasms/diagnosis , Eyelid Neoplasms/pathology , Eyelid Neoplasms/therapy , Hidrocystoma/pathology , Hidrocystoma/therapy , Humans , Male , Middle Aged , Sweat Gland Neoplasms/pathology , Sweat Gland Neoplasms/therapyABSTRACT
Hidrocystomas, eccrine and apocrine, are rare cystic lesions that form benign tumors of the sweat glands. In this clinical review, we present a "classic" case of hidrocystoma and review the main epidemiologic, histologic, and clinical features. We also review the effectiveness of experimental treatment methods and present information about associated syndromes and differential diagnosis, focusing especially on hidrocystomas' resemblance to basal cell carcinoma.
Subject(s)
Hidrocystoma/pathology , Hidrocystoma/therapy , Sweat Gland Neoplasms/pathology , Sweat Gland Neoplasms/therapy , Aged , Diagnosis, Differential , Hidrocystoma/complications , Hidrocystoma/etiology , Humans , Male , Prevalence , Sweat Gland Neoplasms/complications , Sweat Gland Neoplasms/etiologyABSTRACT
The clinical and pathological features and treatment of two patients with multiple eccrine hidrocystomas are presented. The first case is characterized by multiple pearly papules with a bluish hue located in the periorbital region and the bridge of the nose. The second case is characterized by multiple, skin-coloured papules located in the periorbital area, forehead, chin and nose. Both were exacerbated by a hot and humid environment. Histopathologically, both demonstrated a unilocular cyst located in the dermis, with a 2-3-layer wall composed of cuboidal epithelium that was non-keratinizing. Treatment with topical atropine sulphate 1% in aqueous solution three times a day was instituted in the first case; however, this was poorly tolerated because of blurred vision and nausea. The lesions were subsequently hyfrecated with a good response. The second case was treated with topical atropine sulphate 1% in aqueous solution three times a day with a good response.