Multiple apocrine hidrocystoma of the face treated with a 1450-nm diode laser.

A 45-year-old Hispanic man presented with a 10-year history of unusual facial lesions that had spread gradually, becoming almost confluent in some areas. There was no family history of similar lesions. Physical examination revealed multiple asymptomatic, skin-colored to bluish papules and cystic nodules measuring 2 to 5 mm in diameter on the patient’s forehead and cheeks (Figure 1). Lancing produced a serous fluid. A biopsy specimen demonstrated a cyst lined by a double-layered apocrine epithelium, with an inner layer of flattened columnar cells containing abundant eosinophilic cytoplasm that showed focal “decapitation” secretion at the luminal border. The outer layer was composed of elongated myoepithelial cells. These features are characteristric of hidrocystoma with apocrine differentiation (Figure 2).