Eccrine Hidrocystomas: Dilated Sweat Duct or Gland…

Hidrocystomas are rare, benign, watery or fluid filled cystic proliferations of the skin.  There are Apocrine and Eccrine sources of Hidrocystomas (EH).  Apocrine Hidrocystomas are cysts that often have multiple locations and demonstrate Apocrine differentiation on histology.  EH are more likely to be unilocular and are comprised of dilated sweat glands or ducts rather than a cystic neoplasm with no decapitation secretion.  EC most commonly occur on the face in adults as solitary, soft, dome-shaped, translucent papules or nodules.  Although often found as single papules at times there may be multiple lesions and they most commonly occur around the eye.

The lesions will often swell with heat exposure or exercise.

HISTOLOGY:  Eccrine hidrocystomas are unilocular cysts that contain one fluid-filled cavity lined with one or two layers of cuboidal cells.

TREATMENT:  These are benign lesions and no treatment is required.  Excision is effective.  Topical atropine ointment 1% scopolamine or scopolamine cream 0.01% (1.2 ml of 0.25% scopolamine eyedrops in 30 grams of Eucerin or an equivalent base) once daily has been used with variable success in patients with multiple lesions.  Care must be take with these topical preparations since pupil size may increase if it gets in the eye.  Carbon dioxide lasers, electrodessication  and pulsed-dye lasers can be effective.  Oral glycopyrrolate, 1 mg twice daily, may be useful in suppressing exercise-induced and hot weather-induced enlargement.  Botulinum toxin injections have also been used successfully.  To read more about EC click HERE, HERE, and HERE.