CO2 laser in the management of eccrine hidrocystomas. a retrospective study

Eccrine hidrocystomas (EH) are benign cystic proliferationsof eccrine glands. They were frst described by Robinson in 1893 [1]. They occur in the facial region, especially around the eyes, and are typically asymptomatic. Clinically, EH may appear as solitary (Smith type) or multiple facial lesions (Robinson type), such as translucent smooth cystic nodules ranging from 1 to 6 mm in diameter. EH color varies from skin colored to blue. Their clinical presentation is similar to other cystic lesions like sebaceous cysts, milia, mucoid cysts, and apocrine hidrocystomas. For this reason, a histological diagnosis is often required [2]. Biopsy reveals a single cyst in the dermis with walls composed of two layers of cuboidal cells. The cyst does not communicate with the epidermis (Figs. 1 and 2). Despite apocrine hidrocystomas, EH histochemically stain positive for S100 protein [3]. The cause of multiple EH has not been clarifed. However, they probably result from pore closure, leading to secondary dilatation of cystic excretory eccrine glands with sweat retention as reported. EH are more frequent in middle-aged women exposed to heat; hot temperature or humid weather causes an increase in their size and number [4]. Therapeutic management of hidrocystomas may present difculties due to the localization, the number of lesions, and the risk of scars. Therefore, many treatments have been suggested, such as surgical excision, electrocauterization, oral and topical anticholinergics, Botox treatments, cryotherapy, and lasers [5]. Currently, the most frequent treatment is the surgical excision that is efective but limited by the risk of scarring and ectropion formation, even if the use of lasers may prevent them. Multiple lasers have been used, such as argon laser, erbium yttrium aluminum garnet laser, erbium yttrium scandium garnet laser, and carbon dioxide laser [6]. Based on the above, the study aims to treat EH with a carbon dioxide (CO2) laser and evaluate the reduction of the risk of side efects and simplify post-treatment management.