Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(2):e2022090 1

Dermatology Practical & Conceptual

Case presentation

An 80-year-old man was referred for a new eyelid papule in 

proximity of a scar from a previously excised basal cell car-

cinoma (BCC) (Figure 1). Based on naked-eye examination, 

recurrent BCC was suspected, and surgery was performed. 

The histopathological features were consistent with apocrine 

hidrocystoma (AH).

Teaching point

AH is a benign cystic lesion of the apocrine glands usually 

found on the head and neck, particularly periocular [1].  

When arising in or around scars of patients with previ-

ous BCC, diagnosis becomes challenging. Dermoscopy 

might be a helpful tool. Our patient prior BCC showed 

eyelash destruction, in-focus arborizing telangiecta-

sias2 and blotches and strands on dermoscopy (Figure 1,  

A and B) [2]. AH, on the other hand, was clinically simi-

lar but on dermoscopy it had translucent homogenous ar-

eas, linear whitish structures, and no eyelash involvement, 

as previously reported in literature (Figure 1, B-F) [1,2]. 

Dermoscopy might help differentiate recurrent BCC from 

other adnexal tumors, potentially avoiding unnecessary 

procedures.

Dermoscopy as an Aid in the Differentiation of 
Recurrent Eyelid Basal Cell Carcinoma Versus 

apocrine Hidrocystoma
Leonel Hidalgo1, Eugenia Abusleme2, Cristián Navarrete-Dechent1,3, Álvaro Abarzúa-Araya1,3

1 Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

2 Department of Ophthalmology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

3.Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

Citation: Hidalgo L, Abusleme E, Navarrete-Dechent C, Abarzúa-Araya A. Dermoscopy as an aid in the differentiation of recurrent 
eyelid basal cell carcinoma versus apocrine hidrocystoma. Dermatol Pract Concept. 2022;12(2):e2022090. DOI: https://doi.org/10.5826/
dpc.1202a90

Accepted: October 12, 2021; Published: April 2022

Copyright: ©2022 Hidalgo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, 
distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Álvaro Abarzúa-Araya, MD, IFAAD, Department of Dermatology, Escuela de Medicina, Pontificia Universidad 
Católica de Chile, Diagonal Paraguay 362, 6th floor, Santiago, Chile 8330077. E-mail: alvaroabarzuaaraya@gmail.com



2 Image Letter | Dermatol Pract Concept. 2022;12(2):e2022090

References

1. Zaballos P, Banuls J, Medina C, Salsench E, Serrano P, Guion-

net N. Dermoscopy of apocrine hidrocystomas: a morphological 

study. J Eur Acad Dermatol Venereol. 2014;28(3):378-381. DOI: 

10.1111/jdv.12044. PMID: 23198900.

2. Williams NM, Navarrete-Dechent C, Marghoob AA, Abar-

zua-Araya A, Salerni G, Jaimes N. Differentiating basal cell 

carcinoma from intradermal nevi along the eyelid margin with 

dermoscopy: A case series. J Am Acad Dermatol. 2021;84(1):173-

175. DOI: 10.1016/j.jaad.2020.04.059. PMID: 32330634. PM-

CID: PMC8442835

Figure 1. A 80-year-old man referred for a new eyelid papule in proximity of a scar from a previously excised basal cell carcinoma. (A) Pearly 

papule with eyelash destruction. Histopathology confirmed a basal cell carcinoma. (B) Dermoscopy showing eyelash destruction, in-focus 

arborising telangiectasias, and blotches and strands (polarized dermoscopy, x10). (C)  Homogeneous skin colored papule near previous scar. 

Histopathology confirmed an apocrine hidrocystoma. (D) Dermoscopy showing no eyelash involvement and linear whitish structures (po-

larized dermoscopy, x10). (E) Dermoscopy showing translucent homogenous area and no eyelash involvement (non-polarized dermoscopy, 

x10). (F) Surgery of the new eyelid papule. Histopathology confirmed an apocrine hidrocystoma.