D Elder

DK Armostrong

Francisco O'Valle

G Blugerman

Jose A Gonzalez-Saavedra

Jose Aneiros Cachaza

Jose Aneiros-Fernandez

K Hashimoto

Mercedes Caba Molina

N Murayanna

PA De Viragh

Salvador Arias-Santiago

English

PubMed

Mercedes Molina

Jose Cachaza

Springer - Publisher Connector

Multiple eccrine hidrocystomas on the upper lip: a case report

Crossref

BioMed CentralCases Journal
ssOpen AcceCase Report
Multiple eccrine hidrocystomas on the upper lip: a case report
Jose Aneiros-Fernandez*1, Jose A Gonzalez-Saavedra2, Salvador Arias-
Santiago3, Mercedes Caba Molina1, Francisco O'Valle1 and 
Jose Aneiros Cachaza1
Address: 1Department of Pathology. University Hospital San Cecilio, Granada, Spain, 2Department of Dermatology. Baza Hospital, Granada, Spain 
and 3Department of Dermatology. University Hospital San Cecilio, Granada, Spain
Email: Jose Aneiros-Fernandez* - janeirosf@hotmail.com; Jose A Gonzalez-Saavedra - saavedra@ugre.es; Salvador Arias-
Santiago - salvadorarias@hotmail.es; Mercedes Caba Molina - cabmolina@ugr.es; Francisco O'Valle - fovalle@ugr.es; 
Jose Aneiros Cachaza - janeiros@ugr.es
* Corresponding author    
Abstract
Background: Multiple eccrine hidrocystomas of de upper lip are bening cystic lesions that are
associated with a chronic course. It is reported in the literature as a rare pathology.
Case report: We describe the case of a 60-year-old woman who was referred to the dermatology
department for presenting multiple lesions translucent papular asymptomic two years of evolution
on the upper lip. Increase in size in summer and physical exercise, improving winter.
Conclusion: To make the diagnosis of multiple eccrine hidrocystomas is necessary clinical and
histopathological findings, taking different lines of treatment.
Introduction
Eccrine hidrocystomas are cystic tumor the sweat glands
ducts, are relatively rare and account less than 1% of
sumitted cutaneous biopsies [1]. They are more frequent
in fermales between 30 and 70 years of age and can occur
as solitary or multiple cyst. Multiple eccrine hidrocystoma
occur more frecuently around the eyes, cheeks, nose and
less frecuently on the upper lip [2].
Case Report
A 60-year-old woman caucasic who was referred to the
dermatology department for presenting multiple lesions
translucent papular asymptomic two years of evolution
on the upper lip. Increase in size in summer and physical
exercise, improving winter (Fig 1). Excision was per-
formed in one of the lesions. The histopathologic showed
one cyst in the thickness of the dermis. The cyst wall com-
posed of 2 layers of cuboidal cells with eosinophilic cyto-
plasm that secrete into the cyst, without decapitation (Fig
2). No evidence of PAS-positive. Inmunohistochemistry
presented positivity for high molecular weight cytokerat-
ins and CEA, and negative for GCDFP-15 (Fig 3). A diag-
nosis of multiple eccrine hydrocystoma was made.
Discussion
The eccrine hidrocystoma has been considered to be true
ectatic eccrine ducts of the dermal portion. The occurrence
of these injuries was caused by retention of sweat favored
by increased temperature and physical exercise [3]. There
is an increased incidence in hyperthyroid patients, possi-
bly related to hyperhidrosis. When the presentation is
simply a cyst it may be mistaken with epidermal inclusión
cyst, mucoid cyst and hidrocystoma apocrine. From the
clinical point of view el eccrine hidrocystoma and apo-
Published: 9 December 2009
Cases Journal 2009, 2:9291 doi:10.1186/1757-1626-2-9291
Received: 11 November 2009
Accepted: 9 December 2009
This article is available from: http://www.casesjournal.com/content/2/1/9291
© 2009 Aneiros-Fernandez et al; licensee BioMed Central Ltd. 
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), 
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Page 1 of 3
(page number not for citation purposes)
Cases Journal 2009, 2:9291 http://www.casesjournal.com/content/2/1/9291crine hidrocystoma are difficult to distinguish; to be diag-
nosed histopathology is necessary. Apocrine
hidrocystoma usually presented as multiple cysts and may
have abundant papillary proyections into the cyst cavity
or only have a simple apocrine type lining cell with large
cytoplasm, PAS-positive diastase resistant granules, show-
ing the beheading events of decapitation surrounded by
myoepithelial cells [4]. However the eccrine hidrocysto-
mas are usually unilocular showing two layers of epitelial
cuboidal without decapitation events or presence of
myoepithelial cells. Have been described associated with
Graves Basedow disease, Goltz-Gorlin and Schopf-Schulz-
Passarge syndromes.
In regard of treatment, when are unique lesions per-
formed surgical excision when are multiple lesions several
treatments have been described with favorable response;
tópica 1% atropine or scopolamine creams, with a 585
Multiple to numerous cystic papules lesions, ranging from 2 to 3 mm in dia eter upper liFigure 1
Multiple to numerous cystic papules lesions, ranging 
from 2 to 3 mm in diameter upper lip.
Low magnification (×10) revealed one cyst in the thickness of the dermis composed of 2 layers f cuboidal cells (Hematox-iline eosi e)Figure 2
Low magnification (×10) revealed one cyst in the 
thickness of the dermis composed of 2 layers of 
cuboidal cells (Hematoxiline eosine).
Inmunohistochemistry presented positivity high molecular weight cytokeratins (A)(×40) and CEA (B) (×40)Fig re 3
Inmunohistochemistry presented positivity high molecular weight cytokeratins (A)(×40) and CEA (B) (×40).Page 2 of 3
(page number not for citation purposes)
Cases Journal 2009, 2:9291 http://www.casesjournal.com/content/2/1/9291Publish with BioMed Central   and  every 
scientist can read your work free of charge
"BioMed Central will be the most significant development for 
disseminating the results of biomedical research in our lifetime."
Sir Paul Nurse, Cancer Research UK
Your research papers will be:
available free of charge to the entire biomedical community
peer reviewed and published immediately upon acceptance
cited in PubMed and archived on PubMed Central 
yours — you keep the copyright
Submit your manuscript here:
http://www.biomedcentral.com/info/publishing_adv.asp
BioMedcentral
mm flashlamp-pupel pulse dye laser and botulim toxim
[5,6].
Eccrine hidrocystoma is not a serius injury but it is a
mainly problem cosmetic.
Consent
Written informed consent was obtained from the patient
for publication of this case report and accompanying
images. A copy of the written consent is available for
review by the Editor-in-Chief of this journal.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
JAF wrote the initial draft of and helped revise the manu-
script. MCM, JAS, SAS and FO obtained consent from the
patients and helped revise the manuscript. JA assisted with
manuscript revision. All authors read approved the final
manuscript.
References
1. De Viragh PA, Szeimies RM, Eckert F: Apocrine cystoadenoma,
apocrine hidrocystoma, and eccrine hidrocystoma: three
distinct tumors defined by expression of keratins and human
milk fat globulin 1.  J Cutan Pathol 1997, 24:249-255.
2. Hashimoto K, Lever WF: Tumors of skin Appendages.  In Derma-
tology in General Medicine 4th edition. Edited by: Fitzpatrick TB, Eisen
AZ, Wolff K, Freedberg IM, Austen KF. McGraw-Hill; 1987:773-793. 
3. Murayanna N, Tsuboi R, Unno K, Ogawa H: Multiple eccrine hid-
rocystomas.  Br J Dermat 1994, 131:585-586.
4. Elder D, Elenitsas R, Jaworsky C, Johnson Lever's B Jr: Histopathol-
ogy of the skin.  8th edition. Edited by: Elder D, Elenitsas R, Jawor-
sky C, Johnson B. Philadelphia Lippincott-Raven; 1997:770. 
5. Armostrong DK, Walsh MY, Corbett JR: Multiple facial eccrine
hidrocystomas: effective topical therapy with atropine.  Br J
Dermatolol 1998, 139:558-559.
6. Blugerman G, Schavelzon D, Dangelo S: Multiple eccrine hidro-
cystoma: a new therapeutic option with botulinum toxin.
2003, 29:557-559.Page 3 of 3
(page number not for citation purposes)


Apocrine cystoadenoma, apocrine hidrocystoma, and eccrine hidrocystoma: three distinct tumors defined by expression of keratins and human milk fat globulin 1. J Cutan Pathol

H: Multiple eccrine hidrocystomas.

Histopathology of the skin. 8th edition. Edited by: Elder

Multiple eccrine hidrocystoma: a new therapeutic option with botulinum toxin.

Multiple facial eccrine hidrocystomas: effective topical therapy with atropine.

WF: Tumors of skin Appendages.

file:///data/core-remote/dit/data/Springer-OA/pdf/e33/aHR0cDovL2xpbmsuc3ByaW5nZXIuY29tLzEwLjExODYvMTc1Ny0xNjI2LTItOTI5MS5wZGY=.pdf

Multiple eccrine hidrocystomas on the upper lip: a case report

Abstract

Similar works

Full text

Available Versions

Springer - Publisher Connector

Crossref

Springer - Publisher Connector