Clinicopathologic Study of 15 Cases of Eccrine Hidrocystoma / 대한피부과학회지

ABSTRACT

BACKGROUND: Eccrine hidrocystoma (EH) represents benign cystic dilatations of previously normal dermal eccrine ducts. It is characterized by tense vesicles or translucent papules most often involving the face, predominantly in a periorbital distribution. There were no data on the clinical and histologic features of EH in Koreans. OBJECTIVE: The purpose of this study is to investigate clinical and histopathological features of EH in Koreans. METHOD: We reviewed the medical records and biopsy slides of 19 cases diagnosed previously as EH in 3 hospitals of Catholic Medical Center from August 1991 to May 2003. RESULT: We could compile clinical data and histologic informations on 15 of the total 19 patients with EH. 1. The mean age at diagnosis was 51.6 years, 54.0 years in females and 32.5 years in males. EH developed predominantly in females as the sex ratio of 1 6.5. 2. Most patients were asymptomatic, but 4 and I patients complained of mild itching and one of a mild burning sensation. The predilection sites were the lower eyelids, nose and lateral canthus. Only one patient had a concomitant Graves' disease. 3. The ratio of Robinson to Smith types was 14 1. The Robinson type had multiple, pinhead-sized, translucent skin-colored lesions, whereas one smith type had two, pea-sized, dark brownish lesions. The former only had seasonal variation, aggravated in warm, humid weather and improved by a cold environment. 4. Histopathologic examination revealed all cases had a single cystic cavity located in the dermis. In 12 of 15 patients, there were eccrine secretory tubules and ducts in close approximation to a cystic cavity, but neither papillary projections of cyst wall nor connections between the epidermis and the cystic cavity could be found in all cases. 5. Various treatments, such as CO2 laser, atropine ointment, cryotherapy or punch excision were tried, but all failed. CONCLUSION: EHs in this study appeared on the face, especially on the lower eyelids of middle-aged women. In contrast to the western literatures in which most EHs are presented as a solitary lesion, Robinson type is much more common in Koreans. There have been no effective treatments for EHs.