Multiple Eccrine Hidrocystomas – from Diagnosis to Treatment: The Role of Dermatoscopy and Botulinum Toxin

Abstract

Background: Eccrine hidrocystomas are rarely described benign cystic lesions, mainly presenting in middle-aged women in the centrofacial area and usually associated with a chronic course, seasonal variability and no proved and consistently efficacious treatments. Case Report: We report 2 patients, a 45- and a 56-year-old woman, with multiple facial eccrine hidrocystomas suggested by dermatoscopy, confirmed by histology and treated with botulinum toxin A with excellent results. Conclusion: Our report stresses the role of dermatoscopy in the diagnosis and follow-up of these lesions, as well as the impact of repeated treatments with botulinum toxin A in eccrine hidrocystomas suggesting it as a first-line treatment for multiple eccrine hidrocystomas because it is easy to use and has no risk of scars.

Carbon dioxide laser combined with botulinum toxin A for patients with periorbital syringomas

“…Eccrine hydrocystomas treated with topical(6) and intralesional (7)(8)(9)(10) botulinum toxin have been reported to have good results. Given that syringomas have a similar origin as eccrine hidrocystomas and that BTXA inhibits secretion of sweat gland, we decided to use BTXA to treat periorbital syringomas.…”

“…(4)(5)(6) In the literature, several case reports have revealed that multiple eccrine hydrocystomas treated with intralesional and topical botulinum toxin had good results. (6)(7)(8)(9)(10)(11) Since syringomas have similar origin as eccrine hidrocystomas and that BTXA inhibits function of sweat glands, the application of BTXA might have some beneficial effects for patients with syringomas. In the current study, we retrospectively evaluated the efficacy of CO2 laser combined with BTXA for treating syringomas and compared its safety and efficacy to CO2 laser only.…”

Multiple translucent papules on the face of a middle-aged woman

“…Successful treatment of eccrine hidrocystomas with botulinum toxin A has also been described recently. [8] Laser (585-nm flash lamppumped pulse dye laser) appears to be a viable and efficient form of treatment of EH, as there is a lower risk of scarring than with surgical intervention. [9] Electrocautery with a fine tipped probe may also be effective.…”

Botulinum toxin: Non cosmetic and off-label dermatological uses

“…There was excellent response at first session in around 80% of both groups with mean duration of 7 months of the drug efficacy (Correia et al, 2009).…”