|Year : 2001 | Volume
| Issue : 2 | Page : 89-90
Multiple apocrine hidrocystomas
RG Torsekar , V Vishalakshi
Department of Dermatology, CSM Hospital & Rajiv Gandhi Medical College, Kalwa, Thane, Maharashtra, India
18, Sri Valli, Rifle Range, Ghatkoper (W), Mumbai-400086, India
Appendageal tumours localized to the head, face and neck region continue to fascinate and confuse the dermatologists. We report a case of multiple apocrine hidrocystomas on the face of a 35 year-old woman. Good cosmetic result was obtained with excision followed by cauterization.
|How to cite this article:|
Torsekar R G, Vishalakshi V. Multiple apocrine hidrocystomas. Indian J Dermatol Venereol Leprol 2001;67:89-90
| Introduction|| |
Appendageal tumours commonly present on the face and scalp, majority of them being relatively benign and are diagnosed only on pathological examination. We report a case of multiple apocrine hidrocystomas in a 35- year - old woman.
| Case Report|| |
A 35- year- old woman presented with asymptomatic lesions on the face since-3 years. The patient had not received any treatment and denied history of any topical application. No seasonal exacerbation or remissions were noted.
Clinically, multiple discrete yellowish dome shaped translucent nodules were seen on the forehead, cheeks and chin varying in size from 2mm to 15mm, surface being smooth. No lesions were seen elsewhere. A diagnosis of multiple steatocystoma or? appendageal tumour was considered.
Biopsy of a lesion revealed a normal epidermis and the dermis showed a large cystic space with papillary projections. There was no connection between the epidermis and the cyst. The cyst wall and papillary projections were lined by a row of secretory cells with decapitation secretion suggesting apocrine origin. [Figure - 1]. A diagnosis of apocrine hidrocystoma was made. Electrofulguration of the remaining lesions was done with a good cosmetic result.
| Discussion|| |
Apocrine hidrocystomas or cystadenomas are benign cystic neoplasms of apocrine origin. Clinically the lesions are characterised by solitary, skin coloured translucent nodular lesions with a bluish hue. These are commonly located on the face. Multiple apocrine hidrocystomas are rarely encountered. A clinical differential diagnosis includes pigmented nevus, melanoma, blue nevus or a cystic basal cell carcinoma.
A diagnosis of apocrine hidrocystoma solely on clinical findings is difficult and clinico- pathological correlation is needed. Histologically a cystic space in the dermis into which papillary projections extend is characteristic and the cyst has no connection with the overlying epidermis. Lining of the cyst is by secretory cells of apocrine nature as illustrated in our case. In syringocystadenoma papilliferum, the lining of cystic invagination is similar, but they extend downwards from the epidermis. Eccrine hidrocystomas differ from apocrine by absence of decapitation secretion, of PAS positive granules and of myoepithelial cells. Also cysts of eccrine origin are unilocular and of apocrine origin tend to be multilocular.
Appendageal tumours on the face pose a cosmetic problem and a therapeutic challenge. A final diagnosis is possible only on histopathology as illustrated by our case. Also, gratifying results were obtained in our patient by electrofulguration.
| References|| |
|1.||Arnold HL, Odoms RB, James WD. Epidermal naevi, neoplasms and cysts. In: Arnold HL, Odoms RB, James WD, eds. Andrews Diseases of the Skin, 8th edition, Philadelphia: WB Saunders. 1990:779. |
|2.||Kruse TV, Khan MA, Hassan MO. Multiple apocrine cystadenomas. Br J Dermatol 1979;100:675. [PUBMED] |
|3.||Lever WF, Schaumburg Lever G. Tumours of the epidermal appendages In: Histopathology of Skin, 7th edition, Philadelphia, JB Lippincott, 1990 : 599. |