Derm Dx: A growth behind the ear with straw-colored fluid - Clinical Advisor

Derm Dx: A growth behind the ear with straw-colored fluid

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A 25-year-old woman presents for evaluation of a growth behind her right ear. The lesion was first noted several weeks ago and is asymptomatic but prone to trauma. Medical history is unremarkable. Examination reveals a 2.5-cm flesh-colored nodule that is semitranslucent and not freely movable. Puncture of the lesion produced straw-colored fluid.

 

Apocrine hidrocystomas are benign cystic tumors of the apocrine sweat glands. The lesions typically present as solitary, asymptomatic nodules that are bluish to clear in coloration. The head and neck are the most common areas affected, although they can arise...

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Apocrine hidrocystomas are benign cystic tumors of the apocrine sweat glands. The lesions typically present as solitary, asymptomatic nodules that are bluish to clear in coloration. The head and neck are the most common areas affected, although they can arise anywhere on the body, including the genitalia.1-3

Diagnosis is usually based on the distinct clinical appearance and location. Differential diagnosis includes eccrine hidrocystoma, epidermal inclusion cyst, and basal cell carcinoma.4

Surgical excision with removal of the cyst wall is curative, as may be simple needle puncture. Carbon dioxide lasers4 and trichloroacetic acid5 have proven effective for treatment of multiple lesions.

Stephen Schleicher, MD, is an associate professor of medicine at the Commonwealth Medical College in Scranton, Pennsylvania, and an adjunct assistant professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

References

  1. Hafsi W, Badri R. Apocrine hidrocystoma. StatPearls. August 2, 2017.
  2. Ribeiro K, Bucciaroni AP, Graziano B, et al: Apocrine hidrocystoma. J Am Acad Dermatol. 2013;68(Suppl 1):AB171.
  3. Val D, Val-Bernal JF. Apocrine hidrocystoma of the foreskin. A case report and review of the literature. Rom J Morphol Embryol.  2017;58:651-653.
  4. Anandasabapathy N, Soldano AC. Multiple apocrine hidrocystomas. Dermatol Online J. 2008;14:12.
  5. Dailey RA, Saulny SM, Tower RN. Treatment of multiple apocrine hidrocystomas with trichloroacetic acid. Ophthal Plast Reconstr Surg. 2005;21:148-150.

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