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Pigmented hidrocystoma of nasal epithelium (PHONE): report of a man with a pigmented hidrocystoma of his nose and literature review


Background: Hidrocystomas are benign tumors of apocrine or eccrine epithelium. They most commonly occur on the head and neck, especially periorbitally. Albeit rare, these adnexal tumors may present as pigmented lesions.

Purpose: To describe a patient with a pigmented eccrine hidrocystoma of his nose and to review the features of other individuals with pigmented hidrocystoma of the nasal epithelium.

Material and Methods: PubMed was used to search the follow terms: hidrocystoma and pigmented. All papers were reviewed and relevant manuscripts, along with their reference citations were evaluated.

Results: A 52-year-old man who presented with a pigmented eccrine hidrocystoma on his nasal bridge was described. The features of three previously described patients with pigmented hidrocystoma of the nose were evaluated. The tumors presented as single or multiple, less than 2mm, blue papules. Our patient’s tumor would intermittently bleed, which prompted consideration of a possible basal cell carcinoma. Biopsy established the diagnosis showing a cystic lesion lined by eccrine epithelium with pigmented secretion within the cyst’s lumen. The cyst content stained positive with Fontana-Masson stain. Our patient’s excisional biopsy resulted in excellent cosmetic appearance and complete removal of the benign adnexal tumor.

Conclusion: Pigmented hidrocystomas may be mistaken for other skin lesions, such as a pigmented basal cell carcinoma and melanoma. A biopsy readily establishes the diagnosis. We respectfully suggest that a hidrocystoma located on the nose that is pigmented be referred to as a PHONE: pigmented hidrocystoma of the nasal epithelium.

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