Apocrine Hidrocystoma

What is Apocrine Hidrocystoma?

Apocrine hidrocystoma is an uncommon, harmless tumor that grows from the sweat gland’s secretory part. This growth typically appears as a colorless, single bump or lump that doesn’t cause any discomfort. It’s often found on the head and neck and is usually between 3 to 15 mm in size. It can also move around under the skin. Although this is rare, the benign tumor can sometimes show up in other places.

Usually, the apocrine hidrocystoma appears as a single growth, but in rare cases, multiple growths can occur. These might signal inherited diseases or a disorder known as ectodermal dysplasia, such as specific types of Goltz-Gorlin syndrome and Schopf-Schultz-Passarge syndrome. The diagnosis of apocrine hidrocystoma is typically confirmed through a histological examination, a test which allows doctors to investigate tissue under a microscope.

What Causes Apocrine Hidrocystoma?

Apocrine hidrocystomas are abnormal growths that develop from sweat glands known as apocrine glands. The exact reasons why these grow abnormally are still unclear. However, exposure to sunlight is thought to possibly increase the likelihood of their formation. It’s important to note that this condition is not associated with running in families.

Risk Factors and Frequency for Apocrine Hidrocystoma

Apocrine hidrocystoma, a certain skin condition, mainly impacts adults between 30 and 70 years old. It’s quite unusual for kids or teens to have this condition. Interestingly, it affects both men and women equally, irrespective of their ethnic background or where they live. It’s also worth mentioning that having multiple apocrine hidrocystomas is a rare scenario.

Signs and Symptoms of Apocrine Hidrocystoma

Apocrine hidrocystomas are a type of skin condition that usually shows up as a single lump, although doctors have seen cases with multiple lumps. These lumps are mostly found within the skin and appear as moderately firm, dome-shaped cysts. They often have a somewhat transparent look, displaying colors like blue, blackish-blue, grey, or purple. The sizes of these cysts can vary, usually ranging between 3 to 15 mm in diameter, though there are rare reports of large variants reaching up to 7 cm. Compared to eccrine hidrocystomas, another type of skin cyst, apocrine hidrocystomas tend to have more pigment. Also, the symptoms of apocrine hidrocystomas don’t change or worsen, even in hot weather.

Apocrine hidrocystomas are usually found on the head, face, and neck; this may be due to the fact that the apocrine glands, the glands that these conditions arise from, are more common in sun-exposed areas. It’s also worth noting that there is a type of skin condition called multiple eccrine hidrocystomas that closely resemble apocrine hidrocystomas. The difference is that eccrine hidrocystomas are usually smaller (approximately 1 to 6 mm in diameter). They also typically exhibit a brown or bluish color which is clearer compared to apocrine hidrocystomas. Moreover, unlike apocrine hidrocystomas, the size and number of eccrine hidrocystomas tend to increase in hotter summer weather, and may go away when the weather becomes cooler.

Testing for Apocrine Hidrocystoma

When looking at a suspected apocrine hidrocystoma (a type of cyst that can form on the body) through a dermoscope, which is a special microscope for skin, certain patterns become visible. Typically, you might see a uniform light gray or blue area, with softer, cotton-like white sections. Sometimes, there may also be lines of blood vessels, or specks of brownish-orange. These colors are caused by various things in our skin cells. The grayish hue is likely due to a substance called sialomucin, while the fluffy white sections are the connective tissue reflecting light. The brownish-orange specks could be due to skin cells storing lots of glycogen, a sugar your body uses for energy.

The main reason for using a dermoscope is to rule out skin cancers, like melanoma or basal cell carcinoma, that might look similar to this type of cyst. Dermoscopy helps to identify features which indicate a malignant, or cancerous, tumor. Having said that, while these cysts can be suspected from such an examination, to truly confirm it is indeed an apocrine hidrocystoma, a sample of the tissue needs to be looked at under a microscope. This is called a histological examination, and is a surefire way to diagnose these cysts.

Treatment Options for Apocrine Hidrocystoma

The main treatment for apocrine hidrocystoma, which is a benign (non-cancerous) condition, involves surgically removing the affected area with a small border of healthy tissue. This method is important for doctors to make a definitive diagnosis. Another option is puncturing the cyst with a needle, but this often leads to the condition recurring locally.

Other successful treatment methods include puncturing the cyst and following up with a special kind of sclerotherapy – a procedure that involves an injection of concentrated sugar solution. This method has worked well for apocrine hidrocystomas occurring on the eyelid.

Another non-surgical alternative involves injecting Trichloroacetic acid into the cyst followed by aspiration, a process where the fluid is drawn out. Botulinum toxin A, commonly known as Botox, has also been effective in treating this condition in some cases.

What else can Apocrine Hidrocystoma be?

What to expect with Apocrine Hidrocystoma

Apocrine hidrocystomas are typically slow-growing and once they reach their full size, they usually stay the same size. They are completely non-cancerous and removing them usually stops them from coming back. While these cysts might cause slight irritation, the effects are generally light or non-existent, and they hardly ever impact sight.

The outlook is mostly good for those with apocrine hidrocystomas, surgery is often the best treatment to permanently get rid of them. However, unique factors like location of the cyst, its size, and a patient’s general health should be kept in mind. Regular check-ups are important to keep an eye on any possible recurrence.

Possible Complications When Diagnosed with Apocrine Hidrocystoma

Apocrine hidrocystomas are generally harmless growths, but they can sometimes cause problems, especially if they’re not treated, or if they show up in unexpected ways.

Possible complications could include:

• Additional or secondary infections: These are rare, but can occur, especially if the growth is injured or if there’s inflammation present. Infected growths can become painful, red, swollen, warm, and start discharging pus. Treating the infection could need antibiotics or even surgical drainage.
• Cosmetic concerns: These growths commonly appear on the face or eyelids and can become a cosmetic issue depending on their size and location. Larger or multiple growths can further affect the way your face looks and can impact a person’s self-esteem negatively.
• Functional problems: In some cases, these growths can become so large they interfere with how your eyelids work. This could cause problems like your eyelid drooping, turning outwards or inwards. Fixing this might require surgery.
• Recurrence: While not common, these growths can sometimes come back after treatment, especially if the growth isn’t completely removed. Dealing with recurrence could need more treatments and long-term close follow-ups.
• Malignant transformation: Although this is very uncommon, there have been rare cases where the growths have turned into a type of skin cancer called hidradenocarcinoma. This emphasizes the need for accurate diagnosis, appropriate treatment, and long-term monitoring of these growths.
• Psychological impact: Long-term skin conditions, especially those that affect the face, can have a big psychological effect, leading to feelings of self-consciousness, anxiety or depression. Helping patients to deal with the emotional aspect of apocrine hidrocystomas is an important part of comprehensive treatment.

Even though they’re ordinarily harmless, apocrine hidrocystomas can sometimes lead to complications like infection, cosmetic concerns, functional problems, chronic discomfort, recurrence and, in very rare cases, cancerous transformation. Treatment plans should be tailored to each individual, addressing both the physical and emotional impacts of the condition.

Preventing Apocrine Hidrocystoma

It’s recommended for patients to see their doctor if they notice a single skin bump or several bumps. Doing this can help the doctor check for the possibility of skin cancer and decide on the right steps to stop any more growths. This is an important part of catching and treating skin conditions early.