Circumscribed Translucent Papule on the Eyelid

A middle-aged man presented with a 1-year-old asymptomatic eyelid lesion. Examination revealed a well-circumscribed, dome-shaped and whitish translucent papule on the right upper eyelid near the medial canthus [Figure 1]. Dermoscopy revealed translucent homogeneous white structureless area occupying almost the entire lesion with in-focus branching and progressively tapering thin linear serpentine vessels extending from periphery towards, but not crossing, the centre [Figure 2]. The clinical and dermoscopic findings were typical of an apocrine hidrocystoma.

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Figure 1:

Well-defined translucent-white dome-shaped papule on the right upper eyelid near the medial canthus.

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Figure 2:

Dermoscopy of apocrine hidrocystoma showing translucent homogeneous white structureless area (black star) and slender linear serpentine branching and progressively tapering vessels (black arrow) extending from the periphery towards, but not crossing the centre. (Polarised dermoscopy [DermLite™ DL3, 3Gen Inc., San Juan Capistrano, CA, USA], ×10).

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Apocrine hidrocystoma is a rare, usually solitary, benign apocrine gland tumour, frequently affecting the head and neck region of middle-aged to elderly individuals with typical clinical and dermoscopic features as described above. Apocrine and eccrine hidrocystomas are clinically and dermoscopically indistinguishable. However, eccrine forms are smaller and more translucent, do not involve eyelid margin, tend to enlarge during summer and may be multiple. Multiple eyelid apocrine hidrocystomas are seen in Schopf–Schultz–Passarge syndrome.