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Apocrine cystadenoma presents another distinct ciinico-pathological entity among the appendage tumours. Ciinically these smali skin coloured, blue or biack cysts can usually be distinguished from basai cell carcinoma, melanocytic naevus, or a vascular lesion provided the possible diagnosis is borne in mind.Histologically the picture is quite distinct and diagnostic.Apocrine cysfiidenoma is a J-jither rare small cystic tumour occurring •almost exclusively around the face auci neck and should in most cases be diagnosahle clinically. The fact that it occurs on the face and neck where apocrine glands are of regular occui-rence, but few in number, but uot in the axillae or groins wliere they are plentiful, suggests that it may well be a hamartomafouK malformafiou rafher than a true benign tumour. These lesions range in colour from flesh coloured translucent lesions through brown ;and bine to deep l)lack, and iu size usually from 0-5 to 1-0 cms. in diameter.There has been some confuKiou l'egarding the nomenclature of these lesions, which have also l)eeii called hidrocystoma (jMontfort 1962). However, the term hidrocystoma has also been applied to a vesicular eru])tiou, which occurs ou tlie faces of middle-aged women exposed to hot conditions (Robinson 1893), aud which is probably the result of eccrine sweat retention. The name apocrine cystadenoma was ]iroposed by Mehregan (1964) who described •seventeen cases, and he was the (irst to delineate clearly the range of clinical and histological features in these lesions. Two of his cases occuri-ed in associafiou with orgauoid uaevi, which again suggests a hamartomatous origin. The name a])ocrine cystadeiioma has been accejited by Montgomery (1967) and by Sandei'sou (1968), although Lever (1967 uses the term apocrine hidrocystoma. However, the name apocrine cystadenoma indicates that these lesions are benign neoplasms or liamai'tomas rather than sinijile retention •cysts and is preferable. Mehregan sets out the evidence for this very well. Gross (1965) in an electrou microscope study showed that the epithelium of these cysts was similar to ordinary apocrine sweat gland epithelium, but "with some definite, regular, small differences. Shelley ct al (1955) appear to have been tlie first to desci'ibe these tumours, reportiug two skin coloured lesions which they regarded as apocriue retention cysts. Mouffort (1962) •described thi'ee cases of "l)lack hidi'ocystoma'' on the face and drew attention to the importauce of this entity in the differential diagnosis of pigmented lesions on the face. Lund (1957) shows a histological iiliotograph of a typical lapocrine cystadenoma which was considered clinically to be a pigmented naevus.Histologically these lesions show one or more cystic spaces lined by •apocrine type epithelium and with a surrouudiug organized connective tissue •sheath. The height of the epithelium vai'ies in diffei'ent lesions and even in

SUMMAHYThe distinctive clinical and histological features of an extensive case of hyperlceraiosis lenticularis perstans and the rapid and complete response to topical applications of betamethasone-2 7-valerate are recorded. No previous record of effective treatment has been described in the four male cases previously recorded in the literature.A 57 year old female has also been studied with a twenty year old history of an unremitting progressive eruption showing the clinical and histological features of hyperkeratosis lenticularis perstans. In this patient initial response to topical therapy with betamethasone-17-valerate is most gratifying, ai^d is the first treatment to influence the signs and symptoms of the disease state.

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