PHOTOCLINIC

Arch Iranian Med 2003; 6(3): 225, 227



PH
OTOCLINIC







A




















B
C








32-year-old woman presented with a
in diameter, on the periorbital areas (Figure A).
one- year history of asymptomatic
A skin biopsy specimen was obtained from one
A cystic lesions around her eyes. She had of the lesions (Figures B and C).
no other complaints or history of major illnesses

and had not taken any medications. To the best of

her knowledge, nobody in her family had a similar

dermatologic condition.

Physical examination revealed numerous tense
Your Diagnosis?
translucent cystic nodules, some as large as 8 mm
See page 227 for diagnosis

Archives of Iranian Medicine, Vol 6, No 3, July 2003 225

---

Photoclinic
Photoclinic Diagnosis: Apocrine Hydrocystoma


pocrine hydrocystoma is generally
normal sweat gland. In contrast, in eccrine
regarded as a benign apocrine tumor,
hydrocystoma and other tumors showing
A which is almost always solitary. It is differentiation toward the excretory (ductal)
usually found on the head and neck, but can
component of the gland, myoepithelial cells are
occasionally be seen elsewhere. It equally affects
absent.4
both sexes and most often appears in middle-aged
The treatment of apocrine hydrocystoma is
individuals.1
difficult if they are multiple. There is a report of
Apocrine hydrocystoma usually presents as a
successful treatment of multiple apocrine
translucent tumor with a cystic consistency and
hydrocystomas with carbon dioxide (CO2) laser.5
ranges in color from light gray to dark blue-black.
Our patient was a rare case of multiple apocrine
In its usual solitary form, it is not associated with a
hydrocystomas. She was treated surgically by an
familial incidence, and in contrast to the eccrine
ophthalmologist and had a cosmetically acceptable
variant, shows no seasonal variation. Multiple
outcome.
apocrine hydrocystomas are only rarely

encountered and may be hallmarks of two rare
References
inherited disorders: the Schopf-Schulz-Passarge

syndrome and a peculiar form of focal dermal
1 Smith JD, Chernosky ME. Apocrine hydrocystoma
(cystadenoma). Arch Dermatol. 1974; 109: 700 – 22.
hypoplasia.2
2 Alessi E, Gianotti R, Coggi A. Multiple apocrine
Histologically, apocrine hydrocystoma shows
hydrocystomas of the eyelids. Br J Dermatol. 1997; 137:
one or several large cystic spaces located in the
642 – 5.
dermis into which papillary projections often
3 Elder D, Elentisas R, Ragsdale BD. Tumors of the
epidermal appendages. In: Elder D, Elentisas R, Jaworsky
extend. The inner surface of the wall and the
C, et al, eds. Histopathology of the Skin. Philadelphia, Pa:
papillary projections are lined with a row of
Lippincott-Raven; 1997: 747 – 803.
secretory cells of variable height, showing
4 Eckert F, Betke M, Schmoeckel C, et al. Myoepithelial
decapitation secretion indicative of apocrine
differentiation in benign sweat gland tumors,
secretion; peripheral to the layer of secretory cells,
Demonstrated by a monoclonal antibody to alpha-smooth
muscle actin. J Cutan Pathol. 1992; 19: 294 – 301.
are elongated myoepithelial cells.3 Eccrine

5 Bickley LK, Goldberg DJ, Imaeda S, et al. Treatment of
hydrocystoma differs from the apocrine variant in
multiple apocrine hydrocystomas with the carbon dioxide
the absence of decapitation secretion of PAS-
(CO2) laser. J Dermatol Surg Oncol. 1989; 15: 599 – 602.
positive granules and lack of myoepithelial cells.3

Using a monoclonal antibody to alpha-smooth
Javad Golchai MD*, Omid Zargari MD*,
muscle actin in benign sweat gland tumors,
Mohammad-Reza Sabouri MD**, *Department of
myoepithelial cells have been identified in most
Dermatology, **Department of Ophthalmology,
sweat gland tumors that have an inclination to
Guilan University of Medical Sciences, Rasht,
differentiate toward the secretory coil of the
Iran.

























Archives of Iranian Medicine, Vol 6, No 3, July 2003 227

---