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Pigmented eyelid cysts revisited: apocrine retention cyst chromhidrosis.

Publication ,  Journal Article
Al-Rohil, RN; Meyer, D; Slodkowska, EA; Carlson, JA
Published in: Am J Dermatopathol
April 2014

A minority of eyelid hidrocystomas are pigmented containing brown-black contents. Chromhidrosis describes the excretion of colored secretions composed of lipofuscin pigments in apocrine gland-rich anatomic locations. The objective of this study is to evaluate the clinicopathologic features of pigmented eyelid cysts. A case-control study was conducted, examining consecutive pigmented and nonpigmented eyelid hidrocystoma excision specimens. Over a 4-year period, 9 pigmented eyelid hidrocystomas were identified, representing 13% (9/70) of all hidrocystoma excisions. Compared to controls (n = 14), no difference existed for age [mean age 59 (44-78 years) vs. 60 (42-82 years)] or size [mean diameter 2.3 (1-4 mm) vs. 2.7 (1-5 mm)] (pigmented vs. nonpigmented, respectively), but a trend for female, left side, and lower lid predominance for pigmented hidrocystomas existed: 8:1 versus 7:7 F:M; 7:2 versus 7:7 left:right; 8:1 versus 9:5 lower:upper eyelid (pigmented vs. nonpigmented, respectively). Clinically, the pigmented cysts' color varied from dark blue, brown, and to black, and on gross examination, they expressed dark brown to black granular liquid contents. Applying histologic criteria of Jakobiec and Zakka, 8 of 9 and 14 of 14 pigmented and nonpigmented hidrocystomas were of apocrine type. Seven of 9 (78%) pigmented cysts and 6 of 14 (43%) nonpigmented hidrocystomas contained granular eosinophilic cyst contents and/or intracellular cytoplasmic granular pigmented deposits by light microscopy. (The pigmented cyst contents did not survive processing in 2 cases.) By histochemistry (periodic acid Schiff with diastase, Sudan Black, and Fite acid-fast positive staining) and ultraviolet fluorescence, these sediments were determined to be lipofuscin pigments. No hidrocystomas had melanin deposits, and one case had hemosiderin deposits in a scarred cyst wall in addition to cyst lipofuscin pigments. In studies of chromhidrosis, both normal and chromhidrotic apocrine glands contain lipofuscin pigments; the sole difference lies in the amount of lipofuscin granules. Similarly, for eyelid apocrine hidrocystomas, lipofuscin pigments exist in both groups. Presumptively, the amount of lipofuscin and degree of its oxidation distinguish pigmented from nonpigmented apocrine hidrocystomas.

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Published In

Am J Dermatopathol

DOI

EISSN

1533-0311

Publication Date

April 2014

Volume

36

Issue

4

Start / End Page

318 / 326

Location

United States

Related Subject Headings

  • Sweat Gland Neoplasms
  • Pigmentation
  • Middle Aged
  • Male
  • Lipofuscin
  • Humans
  • Hidrocystoma
  • Hemosiderin
  • Female
  • Eyelids
 

Citation

APA
Chicago
ICMJE
MLA
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Al-Rohil, R. N., Meyer, D., Slodkowska, E. A., & Carlson, J. A. (2014). Pigmented eyelid cysts revisited: apocrine retention cyst chromhidrosis. Am J Dermatopathol, 36(4), 318–326. https://doi.org/10.1097/DAD.0b013e3182a23a87
Al-Rohil, Rami N., Dale Meyer, Elzbieta A. Slodkowska, and J. A. Carlson. “Pigmented eyelid cysts revisited: apocrine retention cyst chromhidrosis.Am J Dermatopathol 36, no. 4 (April 2014): 318–26. https://doi.org/10.1097/DAD.0b013e3182a23a87.
Al-Rohil RN, Meyer D, Slodkowska EA, Carlson JA. Pigmented eyelid cysts revisited: apocrine retention cyst chromhidrosis. Am J Dermatopathol. 2014 Apr;36(4):318–26.
Al-Rohil, Rami N., et al. “Pigmented eyelid cysts revisited: apocrine retention cyst chromhidrosis.Am J Dermatopathol, vol. 36, no. 4, Apr. 2014, pp. 318–26. Pubmed, doi:10.1097/DAD.0b013e3182a23a87.
Al-Rohil RN, Meyer D, Slodkowska EA, Carlson JA. Pigmented eyelid cysts revisited: apocrine retention cyst chromhidrosis. Am J Dermatopathol. 2014 Apr;36(4):318–326.

Published In

Am J Dermatopathol

DOI

EISSN

1533-0311

Publication Date

April 2014

Volume

36

Issue

4

Start / End Page

318 / 326

Location

United States

Related Subject Headings

  • Sweat Gland Neoplasms
  • Pigmentation
  • Middle Aged
  • Male
  • Lipofuscin
  • Humans
  • Hidrocystoma
  • Hemosiderin
  • Female
  • Eyelids