Two Pilosebaceous Cysts with Apocrine Hidrocystoma in One Biopsy Site: DISCUSSION
Milia is a small dermal cyst which may arise from the pilosebaceous apparatus or eccrine sweat ducts. Histologically, the small cysts are lined by several layers of stratified squamous epithelium with central keratinous material, resembling a small epidermal cyst. They may be connected to a vellus hair follicle or eccrine sweat duct.
EVHC mostly develop as a consequence of occlusion of the infundibulum of vellus hairs with resultant cystic dilatation and retention of keratinous debris and vellus hairs. The characteristic histology is that of a mid-dermal cyst containing laminated keratin and many vellus hairs.
Although milia and EVHC are distinct from one another, in our case, milia and EVHC were revealed at one biopsy site. Patrizi et al suggested that milia and EVHC may represent an early sign of multiple pilosebaceous cystic disease and can be considered as a subtype of a multiple pilosebaceous cyst.
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On the one hand, apocrine hidrocystoma is generally thought to arise by cystic dilatation of apocrine glands normally present in the skin. The lining epithelium is composed of uniform cuboidal apocrine cells that demonstrate decapitation secretion and frequently have papillary projections. In our case, even though the lining epithelium was not totally composed of cuboidal apocrine epithelium, the cyst demonstrated decapitation secretion and was consistent with apocrine hidrocystoma.
