Multiple hidrocystoma of the face: three cases.

Multiple hidrocystomas of the face (Robinson type) is an uncommon variant of hidrocystoma consisting of multiple cysts of the face of middle-aged women with exacerbation in hot temperatures. Controversy about the eccrine or apocrine nature of these lesions has appeared in the literature almost since their original description in 1893. Immunohistochemistry is not helpful in distinguishing between eccrine and apocrine differentiation in these lesions and enzyme histochemical studies have not been conclusive. We report three patients with this rare variant of hidrocystoma. In our opinion, multiple hidrocystomas of the face are apocrine hidrocystomas in which characteristic 'decapitation' secretion has been effaced by the pressure of cyst contents against the lining epithelium; only after serial sections is it possible to identify some areas of the cyst lining showing apocrine secretion in the luminal border of columnar cells.