Both benign and malignant tumors may arise from the cutaneous adnexa (hair follicles, sweat glands, and sebaceous glands).
- A biopsy is usually necessary to establish the diagnosis, except for syringomas.
- Surgical or laser therapy is the only available alternative in most cases, but is only required for malignant or locally aggressive lesions, or when requested by the patient for cosmetic reasons.
- Eccrine hidrocystomas may occasionally be controlled by application of topical atropine 2% in petrolatum twice a day.
In some cases the pathologic interpretation of adnexal tumors may be difficult and their biologic behavior hard to predict. Certain adnexal tumors are cutaneous manifestations of inherited syndromes with significant internal associations (for example, trichilemmoma and Cowden’s syndrome; fibrofolliculoma and Birt-Hogg-Dube syndrome. Consider referral or consultation.