The efficacy of electrosurgery and excision in treating patients with multiple apocrine hidrocystomas

Benign Cutaneous Cysts: A Comprehensive Analysis of 1160 cases

Background Cysts are common skin abnormalities that are mostly benign; however, sometimes malignant lesions may present clinically as cystic manifestations. Benign cutaneous cysts can be of different morphological types and their diagnosis relies on histological evaluations. The most common mode of treatment is surgical excision, which is curative. Methodology This is a retrospective cross-sectional study conducted at the Department of Histopathology, Chughtai Institute of Pathology, Lahore, Pakistan from 1st January 2020 to 31st December 2022. Non-probability consecutive sampling was done, and all the cases of benign cutaneous cysts were included. All cases were microscopically reviewed by two histopathologists, and variables like age, gender, site of the lesion, and histological diagnosis were noted. The data were analyzed using IBM SPSS Statistics for Windows, Version 29 (Released 2022; IBM Corp., Armonk, New York, United States). Results A total of 1160 recorded cases of benign cutaneous cysts were included. Overall gender distribution revealed males (n=489, 42.1%) and females (n=671, 57.8%). The age range was 3 to 91 years with a mean age of 37.56 ± 16.05 years. The three most common cysts were epidermal inclusion cysts (74.3%), trichilemmal cysts (15.1%), and dermoid cysts (6.3%). Other cysts were uncommon including hidrocystoma (1.9%), steatocystoma (0.3%), verrucous cysts (0.3%), comedones (0.6%), hybrid cysts (0.2%), milia (0.3%), and vellus hair cysts (0.2%). The most common site was back (23.5%) for epidermal inclusion cysts, scalp (74.4%) for trichilemmal cysts, and eye (33.8%) for dermoid cysts. Conclusion Benign cutaneous cysts have a broad morphological spectrum with a wide age range. Epidermal inclusion cysts, trichilemmal cysts, dermoid cysts, and hidrocystoma account for the four most common types. For each of the other cyst type, the prevalence was under 1%. Female gender predominated in epidermal inclusion cysts, trichilemmal cysts, and dermoid cysts while male gender was common in other cysts. Overall majority of the cysts presented in the head and neck area.

Eccrine hidrocystoma: a rare ophthalmic entity

Eyelid tumors are the most common neoplasm in routine ophthalmology practice and encompass a wide variety of benign and malignant tumors, predominant being benign tumors. Hidrocystomas are rare, benign, cystic lesions of the skin often found on the head and neck region and typically occurs on the face in adults between 30 and 70 years of age. They are further divided into two groups - apocrine and eccrine hidrocystoma; both closely mimic clinically and morphologically related cystic sweat gland tumors.  We present a “classic” case of eccrine hidrocystoma in a 60 year old female. The cysts are small, clear to blue and size ranging 1 to 6 mm in diameter. Histologically, the cysts are simple and lined by a 2 - 3 wall layers of cuboidal epithelium (non keratinizing), devoid of a myoepithelial layer. Eccrine lobules are often closely apposed, and occasionally the ducts enter the cysts. Immunohistochemically, they stain positive for S100 protein. Management of hidrocystomas mainly involves simple needle puncture with excision en mass. However, other treatment modalities are also available.

Multiple eccrine hidrocystomas in a patient of sarcoidosis

A 45-year-old female patient known case of sarcoidosis presented in skin department with chief complaint of skin-colored papulonodular lesions over face with exacerbation in summer season since last 4 years. On examination lesions were multiple, firm and skin colored. Biopsy was done showing features of eccrine hidrocystoma. Patient was treated with electrocautery and showed improvement.

Cutaneous lesions of the nose

Skin diseases on the nose are seen in a variety of medical disciplines. Dermatologists, otorhinolaryngologists, general practitioners and general plastic and dermatologic surgeons are regularly consulted regarding cutaneous lesions on the nose. This article is the second part of a review series dealing with cutaneous lesions on the head and face, which are frequently seen in daily practice by a dermatologic surgeon. In this review, we focus on those skin diseases on the nose where surgery or laser therapy is considered a possible treatment option or that can be surgically evaluated.

Cutaneous Cysts of the Head and Neck

PURPOSE

This article reviews the types of cutaneous cysts in patients referred to the Facial Lesion Clinic at John Peter Smith Hospital in Fort Worth, TX, and proposes effective treatment modalities based on lesion and patient variables. Cyst variables included proper identification, size of the lesion, and acute or chronic processes. Patient considerations included age, skin type, and location. Medical and social histories were not noted.

PATIENTS AND METHODS

Eighty-two patients who had 1 or more cysts removed over the 5-year period from July 15, 1998 to July 14, 2003 were reviewed for age, gender, histologic diagnosis, anatomic location of the lesion, and complications.

RESULTS

Patients with epidermal inclusion cysts (79%), followed by pilar cysts (9%), hidrocystomas and dermoid cysts (3% each), and multiple other diagnoses (less than 2%) were treated. Neither complications nor recurrent infections were reported during the 5-year interval. There were no recurrent cyst formations noted by return appointment.

CONCLUSION

Cystic lesions of the head and neck may be treated effectively as long as they are correctly identified and treated in a specific manner.