Multiple eccrine hidrocystomas

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.     

Multiple eccrine hidrocystomas of the face

BACKGROUND: Multiple eccrine hidrocystomas of the face are a rare facial dermatosis for which no recent large series of cases has been reported. OBJECTIVE: To describe the clinicopathologic features of five cases of multiple eccrine hidrocystoma and to emphasize their similar characteristics. METHODS: The clinical and histologic features of five women with multiple eccrine hidrocystomas of the face are described. RESULTS: All cases were middle-aged women with numerous, asymptomatic, skin-colored to bluish, papulonodular skin lesions, ranging from 2 to 5 mm in diameter, and mainly centrifacial in distribution. Histopathologically, all cases showed unilocular cysts in the dermis lined by two layers of cuboidal cells. Staining for S-100 protein was negative in the cyst wall in all cases. One case was treated with topical 1% atropine for 3 weeks with no significant improvement. No systemic side-effects were observed during this treatment. CONCLUSIONS: Multiple eccrine hidrocystomas are a rare condition which might be confused clinically and histopathologically with apocrine hidrocystomas. To date, no effective treatment has been reported.     

Multiple eccrine hidrocystomas successfully treated with cryotherapy in a patient with sarcoidosis

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.     

Multiple eccrine hidrocystomas: report of two cases treated unsuccessfully with atropine ointment

Eccrine hidrocystomas are rare, benign, cystic lesions with a lining that resembles that of the eccrine sweat gland and may be solitary or multiple. Multiple eccrine hidrocystomas occur predominantly on the face as asymptomatic, skin-colored to bluish lesions associated with a chronic course and seasonal variability. Treatment of multiple lesions on the face is challenging. Efficacy with atropine ointment is variable. Botulinum toxin and pulsed dye laser are reported to be beneficial. Two cases of multiple eccrine hidrocystomas are reported who showed no response to 1% atropine ointment.     

Multiple apocrine hidrocystomas

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.     

Multiple linear eccrine spiradenoma associated with multiple trichoepithelioma

A 37-year-old woman had multiple trichoepithelioma of the face which showed typical clinical and histological features, together with multiple papular lesions of 30 years' duration. The lesions were arranged in a linear fashion on her right breast and right upper arm. Microscopic examination of a biopsy specimen revealed typical eccrine spiradenomas. An ultrastructural study of the tumor on the breast revealed that it was composed of two main types of cells: one was a clear cell with low-density cytoplasm and the other was a dark cell with high-density cytoplasm. Some of the clear cells had secretory granule-like structures and/or tono-fibrils, while others had intracytoplasmic cavitations. Neither myoepithelial cells nor Langerhans cells were observed.     

Multiple apocrine hidrocystomas

A 83-year-old woman presented with a 7-year history of translucent papules that were scattered diffusely over her nose, peri-orbital region, and cheeks. These lesions were exacerbated by heat and exercise. Histopathologic examination of a biopsy specimen from the cheek showed a thin-walled cyst lined by a flattened bi-layered epithelium that exhibited decapitation secretion in the upper part of the epidermis. A diagnosis of multiple apocrine hidrocystomas was made based on the clinical and histopathologic findings, and the patient is currently considering treatment options. These include electrodesiccation, excision, trichloracetic acid, carbon-dioxide laser, and 1450-nm diode laser.     

Multiple apocrine hidrocystomas of the eyelids

We report a patient with multiple apocrine hidrocystoma (cystadenoma) which was characterized by bilateral distribution of the lesions of the eyelids. The disease is benign, but it may be a marker of two rare inherited disorders, the Schöpf—Schulz—Passarge syndrome and a peculiar form of focal dermal hypoplasia.     

Multiple apocrine hidrocystomas successfully treated with botulinum toxin A

Apocrine hidrocystomas, while rare, present predominantly as solitary papules occurring in the periocular region of the face. Various treatment modalities for these lesions exist depending on their size and location, but the management of multiple hidrocystomas can be more challenging. Recent reports illustrate that multiple eccrine hidrocystomas have been successfully treated with botulinum toxin A. Herein we describe the effective use of botulinum toxin A in a 29‐year‐old man with multiple facial apocrine hidrocystomas, which, to our knowledge, has not yet been reported in the English‐language literature.     

Intralesional botulinum toxin-A injection for the treatment of multiple eccrine hidrocystomas

Background: Multiple eccrine hidrocystomas (MEH) are benign cystic lesions of the sweat gland ducts. They are characterized by translucent, skin-colored or bluish dome-shaped papules on the face, causing cosmetic concern. Recently, botulinum toxin-A, because of its antiperspirant properties, has been used to treat facial MEH. However, there are only some case reports in the literature. Objective: Here, we conducted a prospective study to assess the efficacy and safety of intralesional injection of botulinum toxin-A (Dysport) for the treatment of MEH. Material and Methods: Twenty patients (3 men and 17 women), aged from 31 to 75 years old, participated in this study. A 300 unit vial of botulinum toxin-A (Dysport, Ipsenn Biopharm, United Kingdom) was diluted with 4 ml of saline solution without preservative to achieve a concentration of 7.5U/.1 ml. Up to 1.5 unit of botulinum toxin was injected intradermally at the base of each lesion to raise a visible wheal. The patients were evaluated 7 days later, and any clinical changes or adverse effects were recorded. Results: In all patients, more than 75% of eccrine hidrocystoma lesions resolved without any scaring. The result sustained for 2–5 months. In two patients mild smile asymmetry and in one patient lagophthalmos were noted approximately 5–7 days after injection that gradually resolved in 3 weeks. Conclusion: Intralesional botulinum toxin-A for treatment of multiple hidrocystomas is a simple and well-tolerated procedure. It is accompanied by excellent results, a good postoperative course, and no risk of scarring. It can be considered in patients who did not respond to other treatment or even as the first line therapy.     

Multiple apocrine hidrocystomas on the eyelids

A 31-year-old man with multiple cystic tumors symmetrically distributed on his eyelids is presented. Histopathology and immunohistochemistry suggest the diagnosis of apocrine hidrocystomas. Apocrine hidrocystomas occur frequently on the face, but multiple and symmetrical occurrence on the eyelids has not been reported up to now.     

Multiple familial eccrine spiradenoma with cylindroma

This report documents an association between multiple eccrine spiradenomata and multiple cylindromata in three generations of one family and provides further evidence to support previous contentions that these tumours are derived from a pluripotential basal cell. We propose that eccrine spiradenoma may be inherited as an autosomal dominant.