ABSTRACT
Multiple eccrine hidrocystomas are benign cysts of eccrine duct and occur mainly in middle aged women with numerous translucent papules on the central face. The treatment of multiple eccrine hidrocystomas is difficult because of their numbers and location. We propose a combined therapeutic method of botulinum toxin and electrosurgery for widely spreading eccrine hidrocystomas. Botulinum toxin inhibits sweating by temporarily blocking the release of acetylcholine from cholinergic neurons that innervate sweat glands. Electrosurgical energy is transmitted along cystic fluid and destructs cystic walls. A 62-year-old woman presented with multiple translucent papules on the face and was diagnosed with multiple eccrine hidrocytomas. Electrocoagulation was performed at a low power setting on the whole face and botulinum toxin was injected intradermally for microcystic lesions on the whole face except upper eyelids. The condition was controlled successfully for 4 months. We think that botulinum toxin and fine needle electrocoaglation are effective treatments for multiple eccrine hidrocytomas.