Asunto(s)
Hidrocistoma , Neoplasias de las Glándulas Sudoríparas , Humanos , México/epidemiología , Hidrocistoma/patología , Hidrocistoma/tratamiento farmacológico , Hidrocistoma/diagnóstico , Femenino , Masculino , Persona de Mediana Edad , Neoplasias de las Glándulas Sudoríparas/patología , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Adulto , Derivación y Consulta , Neoplasias Orbitales/tratamiento farmacológico , Neoplasias Orbitales/diagnóstico , Anciano , Toxinas Botulínicas Tipo A/administración & dosificación , Toxinas Botulínicas/administración & dosificaciónRESUMEN
Introdução: Hidrocistomas são cistos cor da pele ou translúcidos, únicos ou múltiplos, que aparecem na face. Têm origem na glândula sudorípara écrina ou apócrina e, às vezes, são desfigurantes. Podem ser tratados com cirurgia, eletrodissecção ou cáusticos, mas costumam ser recidivantes e os tratamentos podem deixar cicatrizes ou discromias. A toxina botulínica A (BoNT-A) foi sugerida como terapia em poucos casos na literatura. Objetivo: Analisar os efeitos da toxina botulínica em casos de hidrocistoma da face. Métodos: Estudo observacional retrospectivo de série de casos. Foram avaliados pacientes portadores de hidrocistoma na face, tratados com BoNT-A. Resultados: De 13 pacientes avaliados, cinco foram incluídos, a maior casuística descrita até o momento. Destes, todas as lesões tratadas apresentaram melhora clínica durante o período avaliado. Quatro pacientes mostraram regressão parcial e um, regressão total das lesões. Conclusões: Nesta série de casos, a BoNT-A mostrou resultados positivos e duradouros no tratamento de hidrocistomas faciais, sem efeitos adversos.
Introduction: Hidrocystomas are skin-colored or translucent cysts, single or multiple, appearing on the face. They originate in the eccrine or apocrine sweat gland and are sometimes disfiguring. They can be excised by surgery, electrodissection, or by caustics, but are usually recurrent and the treatments can leave scars or dyschromia. Botulinum toxin A (BoNT-A) has been suggested as therapy in few cases in the literature. Objective: To analyze the effects of BoNT-A in cases of facial hidrocystomas. Methods: Retrospective observational study of case series. Patients with facial hidrocystomas treated with BoNT-A at the Cosmiatry Outpatient Dermatology Clinic of the Hospital do Servidor Público Municipal de São Paulo, were evaluated. Results: Of the 13 patients evaluated, 5 were included, the largest case series described so far. Of these, all lesions treated showed clinical improvement during the period evaluated. Four patients showed partial regression and one, total regression of the lesions. Conclusion: In this series of cases, BoNT-A showed positive and long-lasting results in the treatment of facial hidrocytsomas, with no adverse effects.
Asunto(s)
Terapéutica , Hidrocistoma , Toxinas Botulínicas Tipo ARESUMEN
Los hidrocistomas apocrinos son lesiones quísticas benignas. Clínicamente se caracterizan por ser nódulos quísticos claros o traslucidos, solitarios, en forma de cúpula, con superficie lisa. En la mayoría de los casos la localización suele ser alrededor del ojo, particularmente lateral al canto externo. Suelen ser asintomáticos, de crecimiento lento pudiendo llegar a 10 mm de diámetro o más. Presentamos un caso de un paciente con un hidrocistoma apocrino variante pigmentada.
Apocrine hydrocystomas are benign cystic lesions, clinically characterized by being clear or translucent cystic nodules, solitary, domeshaped, with a smooth surface. In most cases the location is usually around the eye, particularly lateral to the outer edge. They are usually asymptomatic, slow growing and can reach 10 mm in diameter or more. We present a case of a patient with a pigmented variant apocrine hydrocystom
Asunto(s)
Humanos , Persona de Mediana Edad , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Hidrocistoma/diagnóstico , Dermoscopía/métodos , Glándulas Apocrinas , Neoplasias de las Glándulas Sudoríparas/patología , Hidrocistoma/patologíaRESUMEN
RESUMO INTRODUÇÃO: Hidrocistoma é uma forma cística de adenoma de glândula sudorípara. É um tumor benigno, mais presente em mulheres de meia idade. As lesões possuem aspecto desfigurante e caráter recidivante. Não há tratamento padrão-ouro e, recentemente a toxina botulínica surgiu como mais uma opção terapêutica. TIPO DE ESTUDO: Estudo observacional retrospectivo de série de casos. MÉTODOS: Pacientes portadores de hidrocistoma na face atendidos no ambulatório de Dermatologia do Hospital do Servidor Público Municipal de São Paulo que foram tratados com toxina botulínica do tipo A. RESULTADOS: Das lesões avaliadas segundo a eficácia terapêutica, todas apresentaram melhora clínica durante o período avaliado. Quatro pacientes mostram regressão parcial e um paciente apresentou regressão total das lesões. DISCUSSÃO: Os pacientes que receberam doses mais altas da neurotoxina não apresentaram melhora clínica superior aos que receberam doses mais baixas. O número de aplicações da toxina botulínica também não propiciou uma melhor resposta clínica dos hidrocistomas. CONCLUSÃO: O exato mecanismo de ação da toxina botulínica ainda é desconhecido. Após 120 dias de acompanhamento clínico, todos os pacientes tratados apresentaram algum grau de melhora clínica. Descritores: hidrocistoma; toxina botulínica; tratamento hidrocistoma.
Asunto(s)
Humanos , Masculino , Femenino , Toxinas Botulínicas , HidrocistomaRESUMEN
BACKGROUND: Apocrine hidrocystomas, also known as apocrine cystadenomas, are bening cystic tumours derived from the secretory portion of apocrine sweat glands. CLINICAL CASE: A 78-year old female was referred to our division for assesment an asymptomatic translucent, well-defined cystic lesion located on the upper helix. The histological features were consistent with apocrine hidrocystoma coexisting with gouty tophi. CONCLUSIONS: We report the second case of apocrine hydrocystoma located in the pinna, outside of ear canal and the first case of its association with gouty tophi described. It is difficult to know which lesion was first established and if the tophi may lead to ductal obstruction and subsequent cystic retention.
Introducción: los hidrocistomas apocrinos, también conocidos como cistoadenomas apocrinos, son lesiones quísticas benignas derivadas de la porción secretora de las glándulas apocrinas. Caso clínico: remiten al servicio de Dermatología a una mujer de 78 años para valorar una lesión asintomática translúcida, bien definida, localizada en la porción superior del hélix. Los hallazgos histológicos fueron compatibles con un hidrocistoma apocrino asociado a tofo gotoso. Conclusiones: reportamos el segundo caso de hidrocistoma apocrino localizado en el pabellón auricular externo y el primer caso asociado a tofo gotoso. Es difícil de conocer qué lesión se estableció primero, y si el tofo gotoso pudo provocar una obstrucción ductal con la subsiguiente retención quística.
Asunto(s)
Glándulas Apocrinas/patología , Pabellón Auricular/patología , Neoplasias del Oído/diagnóstico , Gota/diagnóstico , Hidrocistoma/diagnóstico , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Anciano , Neoplasias del Oído/complicaciones , Neoplasias del Oído/patología , Femenino , Gota/complicaciones , Gota/patología , Hidrocistoma/complicaciones , Hidrocistoma/patología , Humanos , Neoplasias de las Glándulas Sudoríparas/complicaciones , Neoplasias de las Glándulas Sudoríparas/patologíaRESUMEN
ABSTRACT The authors report the first case in Brazilian literature of orbital apocrine hidrocystoma with immunohistochemistry confirmation. The tumor had been growing slowly and progressively, there was no history of impaired vision, diplopia, watering, discharge, or prior trauma. There was no proptosis and extraocular mobility was normal. The radiologic study by orbital computerized tomography revealed an extraconal nodule, with partially defined limits, with cystic and solid areas in the superomedial right orbit. An anterior orbitotomy, with full excision of the tumor was performed. A histopathology examination revealed apocrine hidrocystoma and immunohistochemistry confirmed the diagnosis. After surgery, the patient had total remission of symptoms.
RESUMO Os autores relatam o primeiro caso de hidrocistoma apócrino orbitário com confirmação imunohistoquímica. O tumor apresentou crescimento lento e progressivo, sem relato de baixa de acuidade visual, diplopia, epífora, secreção ou trauma prévio. Não houve proptose ou alteração da motilidade extraocular. O exame de imagem por tomografia computadorizada da órbita revelou uma lesão nodular, extraconal, de limites imprecisos, com áreas císticas e sólidas no seu interior, na região súpero-medial de órbita direita. O paciente foi submetido à orbitotomia por via anterior, com exérese integral da tumoração. O exame histopatológico revelou o diagnóstico de hidrocistoma apócrino e a imunohistoquímica confirmou o diagnóstico. Após a cirurgia, o paciente teve regressão total dos sintomas.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Neoplasias Orbitales/diagnóstico , Inmunohistoquímica/métodos , Hidrocistoma/diagnóstico , Glándulas Apocrinas/patología , Neoplasias de las Glándulas Sudoríparas/cirugía , Neoplasias de las Glándulas Sudoríparas/patología , Biopsia , Neoplasias Orbitales/cirugía , Neoplasias Orbitales/patología , Biomarcadores de Tumor , Tomografía Computarizada por Rayos X , Hidrocistoma/cirugía , Hidrocistoma/patología , Párpados/patologíaRESUMEN
Background: Eyelid apocrine hidrocystoma (AH) is a benign cystic lesion originating from the glands of Moll. These eyelid lesions are rare in cats and there are few cases reported in the literature. The aetiopathogenesis of AH is unknown and the lesion has been interpreted either as proliferative adenomatous tumour or as retention cyst. Definitive diagnosis requires biopsy with microscopic examination. Treatment options for eyelid AH include surgical excision, drainage through aspiration, cryosurgery with liquid nitrogen and chemical ablation. The aim is to report a case of bilateral multiple AH of the eyelids in a cat that was successfully treated with surgical excision. Case: A 5-year-old male Himalayan cat was referred to the Ophthalmology Section in the Veterinary Clinics Hospital of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil with a history of pigmented masses in both eyes that had been progressively enlarging over a 1-year period. Ophthalmic examination revealed two cysts on the medial canthus at the eyelid margin in both eyes. In the left eye was observed mild blepharospasm and lacrimation. Cysts were soft, smooth, round and filled with a dark brownish pigment. The remainder of the ophthalmic examination was unremarkable. Surgical excision of the cysts was indicated with a safety margin. The surgical procedure was performed under [...]
Asunto(s)
Animales , Gatos , Glándulas Apocrinas/veterinaria , Hidrocistoma/cirugía , Hidrocistoma/etiología , Hidrocistoma/veterinaria , Adenoma de las Glándulas Sudoríparas/veterinariaRESUMEN
Background: Eyelid apocrine hidrocystoma (AH) is a benign cystic lesion originating from the glands of Moll. These eyelid lesions are rare in cats and there are few cases reported in the literature. The aetiopathogenesis of AH is unknown and the lesion has been interpreted either as proliferative adenomatous tumour or as retention cyst. Definitive diagnosis requires biopsy with microscopic examination. Treatment options for eyelid AH include surgical excision, drainage through aspiration, cryosurgery with liquid nitrogen and chemical ablation. The aim is to report a case of bilateral multiple AH of the eyelids in a cat that was successfully treated with surgical excision. Case: A 5-year-old male Himalayan cat was referred to the Ophthalmology Section in the Veterinary Clinics Hospital of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil with a history of pigmented masses in both eyes that had been progressively enlarging over a 1-year period. Ophthalmic examination revealed two cysts on the medial canthus at the eyelid margin in both eyes. In the left eye was observed mild blepharospasm and lacrimation. Cysts were soft, smooth, round and filled with a dark brownish pigment. The remainder of the ophthalmic examination was unremarkable. Surgical excision of the cysts was indicated with a safety margin. The surgical procedure was performed under [...](AU)
Asunto(s)
Animales , Gatos , Hidrocistoma/veterinaria , Hidrocistoma/etiología , Hidrocistoma/cirugía , Glándulas Apocrinas/veterinaria , Adenoma de las Glándulas Sudoríparas/veterinariaRESUMEN
INTRODUÇÃO: O hidrocistoma palpebral écrino corresponde a lesão cística rara, usualmente de pequenas dimensões, não ultrapassando o diâmetro de 10 mm. Sua abordagem usualmente é por excisão simples e biópsia. É alto o índice de recidiva local. MÉTODOS: Paciente com múltiplos hidrocistomas bilaterais, vários maiores que 10 mm. Sob anestesia local, foi realizada incisão infraciliar tradicionalmente usada para blefaroplastia inferior e retirada dos hidrocistomas com cápsula íntegra. RESULTADOS: Paciente com excelentes resultados estéticos e sem recidivas até o presente momento, mais de seis meses após o procedimento. CONCLUSÃO: A incisão infraciliar de blefaroplastia inferior é uma técnica promissora para exérese de hidrocistomas maiores que 10 mm. Mais estudos devem ser realizados para confirmação do bom resultado estético-funcional desta técnica.
INTRODUCTION: Eccrine eyelid hidrocystoma is a rare cystic lesion, usually small and not exceeding 10 mm in diameter. Its treatment is usually by simple excision and biopsy. The rate of local recurrence is high. METHODS: A patient presented with multiple bilateral hidrocystomas, several larger than 10 mm. Under local anesthesia, an infraciliary incision traditionally used for lower blepharoplasty was performed, and hidrocystomas with intact capsules were withdrawn. RESULTS: The patient had excellent esthetic results, with no recurrence for more than six months after the procedure. CONCLUSION: The infraciliary lower blepharoplasty incision is a promising technique for excising hidrocystomas larger than 10 mm. More studies should be conducted to confirm the good esthetic and functional outcomes of this technique.
Asunto(s)
Humanos , Femenino , Anciano , Historia del Siglo XXI , Recurrencia , Cirugía Plástica , Neoplasias de las Glándulas Sudoríparas , Informes de Casos , Hidrocistoma , Adenoma de las Glándulas Sudoríparas , Blefaroplastia , Estudio de Evaluación , Estética , Párpados , Lidocaína , Cirugía Plástica/métodos , Neoplasias de las Glándulas Sudoríparas/cirugía , Neoplasias de las Glándulas Sudoríparas/patología , Hidrocistoma/cirugía , Hidrocistoma/patología , Adenoma de las Glándulas Sudoríparas/cirugía , Adenoma de las Glándulas Sudoríparas/patología , Blefaroplastia/métodos , Párpados/cirugía , Párpados/patología , Lidocaína/uso terapéutico , Lidocaína/farmacologíaRESUMEN
Los siringomas son nevos benignos derivados del epitelio ductal intraepidermico de las glándulas sudoríparas ecrinas (acrosiringio). Predomina en mujeres y la variedad más frecuente es la de localización palpebral. La forma eruptiva es rara. Presentamos un varón de 29 años de edad, con siringomas múltiples eruptivos y compromiso en cara, antebrazos,abdomen y muslos con poca respuesta a tretinoína...
Asunto(s)
Adenoma de las Glándulas Sudoríparas/diagnóstico , Hidrocistoma , Siringoma/diagnósticoRESUMEN
Our patient is a 29-year-old woman without any previous disease who presented with different kinds of lesions on her face, neck, and chest. She first noticed the lesions 10 years ago and, since that time, they have become more numerous. She has no affected relatives. On physical examination, she had multiple cystic lesions on her neck, chest, and vulva, which were between 0.3 cm and 1 cm and skin-colored or yellowish (Figure 1). She presented with small, white papules on her face measuring approximately 0.2 cm, localized on her forehead and cheeks. Some of these papules had a blueish appearance (Figure 2). She also presented clinically typical eruptive syringomas on her upper and lower eyelids and neck and multiple facial milia. Finally, a sacrococcygeal pilonidal cyst was diagnosed and surgically removed. Her nails and teeth were clinically normal. Biopsies of each kind of lesion were performed, with the following results: (1) neck cystic lesion: steatocystoma; (2) small, white facial papule: eccrine hidrocystoma; (3) blueish facial papule: apocrine hidrocystoma; and (4) small neck papule: syringoma (Figure 3). With these findings, our diagnosis was steatocystoma multiplex with multiple eccrine and apocrine hidrocystomas, eruptive syringomas, and sacrococcygeal pilonidal cyst.
Asunto(s)
Hidrocistoma/diagnóstico , Queratina-17/genética , Esteatocistoma Múltiple/diagnóstico , Siringoma/diagnóstico , Adulto , Biopsia , Femenino , Hidrocistoma/genética , Hidrocistoma/patología , Humanos , Seno Pilonidal/diagnóstico , Seno Pilonidal/genética , Seno Pilonidal/patología , Región Sacrococcígea , Esteatocistoma Múltiple/genética , Esteatocistoma Múltiple/patología , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Neoplasias de las Glándulas Sudoríparas/genética , Neoplasias de las Glándulas Sudoríparas/patología , Siringoma/genética , Siringoma/patologíaRESUMEN
Os hidrocistomas écrinos são lesões raras, císticas e benignas, que resultam em deformidades nas regiões palpebrais bilateralmente. Vários tratamentos são citados na literatura, porém nenhum deles é considerado padrão de referência. Deve-se somar as impressões obtidas à avaliação clínica e aos recursos disponíveis. Paciente de 73 anos, feminino, apresentando tumorações em regiões palpebrais bilaterais, de crescimento lento, com obstrução parcial do campo de visão e ectrópio. Foi submetida a dois procedimentos cirúrgicos para ressecção, em 2007 e em 2008. Apresentou melhora significativa do contorno palpebral bilateral, com boa simetria entre as regiões. O exame histopatológico concluiu: hidrocistoma écrino. O tratamento cirúrgico para a polipose palpebral bilateral relacionada ao hidrocistoma écrino mostrou-se uma modalidade que pode apresentar bons resultados estéticos e funcionais, sendo reprodutível, e sem causar maiores morbidades pós-operatórias ao paciente.
Eccrine hidrocystomas are rare lesions, cysts, or benign tumors, which lead to bilateral deformities in the eyelid areas. Several treatments are described in the literature. However, none of them has been established as the gold standard. Hence, it becomes necessary to consider the contribution of different opinions and available resources to clinical evaluation. A 73-year-old female patient presented with slow-growing tumors on both eyelids, which consequently led to partial visual field obstruction and ectropion. She underwent 2 surgical resections, one in 2007 and the other in 2008. As a result, she showed significant improvement of the bilateral eyelid contours and satisfactory symmetry between the areas. Histopathological diagnosis indicated eccrine hidrocystoma. The surgical treatment of bilateral eyelid polyposis associated with eccrine hidrocystoma proved to be a reproducible procedure that may ensure satisfactory aesthetic and functional results, without causing major postoperative morbidities to the patient.
Asunto(s)
Humanos , Femenino , Anciano , Cirugía Plástica , Neoplasias de las Glándulas Sudoríparas , Neoplasias de las Glándulas Sudoríparas/cirugía , Glándulas Sudoríparas , Hidrocistoma , Neoplasias de los Párpados , Párpados , Cara , Cirugía Plástica/métodos , Glándulas Sudoríparas/anomalías , Glándulas Sudoríparas/cirugía , Glándulas Sudoríparas/crecimiento & desarrollo , Hidrocistoma/cirugía , Neoplasias de los Párpados/cirugía , Párpados/cirugía , Cara/cirugíaRESUMEN
A 52-year-old man presented with a 5-year history of multiple bilateral apocrine hidrocystomas of the eyelids. For the past 3 years, the patient had developed a mechanical ectropion of the right inferior eyelid secondary to progressive enlargement of the lesions. Different therapeutic options were discussed with the patient. Surgical excision of all lesions was performed under local anesthesia. There was no recurrence after 15 months of follow-up.
Asunto(s)
Neoplasias de los Párpados/patología , Hidrocistoma/patología , Neoplasias Primarias Múltiples/patología , Neoplasias de las Glándulas Sudoríparas/patología , Blefaroplastia , Neoplasias de los Párpados/cirugía , Hidrocistoma/cirugía , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Primarias Múltiples/cirugía , Neoplasias de las Glándulas Sudoríparas/cirugíaAsunto(s)
Humanos , Masculino , Persona de Mediana Edad , Hidrocistoma/cirugía , Hidrocistoma/patología , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/patología , Neoplasias de las Glándulas Sudoríparas/cirugía , Neoplasias de las Glándulas Sudoríparas/patología , Diagnóstico Diferencial , Pabellón AuricularAsunto(s)
Humanos , Masculino , Persona de Mediana Edad , Hidrocistoma/cirugía , Terapia por Láser , Neoplasias Cutáneas/cirugía , Neoplasias de las Glándulas Sebáceas/cirugía , Biopsia , Diagnóstico Diferencial , Hidrocistoma/diagnóstico , Hidrocistoma/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/patología , Resultado del TratamientoRESUMEN
This report describes the case of a hidrocystoma of the eyelid and the surgical technique used in the therapeutical management of benign cystic lesions of the eyelids. Hidrocystomas are relatively common benign lesions of the eyelids, principally the lower eyelid. They are more common in females over thirty years of age. Diagnosis is clinical and when there is a single lesion, surgery is the treatment of choice. The surgical technique used should be described in greater detail, since it offers good esthetic results and a low risk of recurrence.
Asunto(s)
Neoplasias de los Párpados/cirugía , Hidrocistoma/cirugía , Neoplasias de las Glándulas Sudoríparas/cirugía , Adulto , Femenino , HumanosRESUMEN
This is a case report followed by a short review of literature of apocrine hidrocystomas. A 67 year old lady came to this clinic with multiple translucent, asymptomatic papulocystic lesions on the face which got worse in summer. A biopsy showed a single cystic cavity lined by two layers of small cuboial epithelial cells was seen. Apocrine differentiation characterised by decapitation secretion was seen. A diagnosis of multiple apocrine hidrocystomas was made. Treatment can be attempted with individual excision of lesions or lasers. Topical atropine and scopolamine too have been tried with variable success. Our patient did not wish any treatment once the benign nature of the condition was confirmed.