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Marc E. Boddicker, MD
Department of Dermatology University of Iowa Hospitals and Clinics Iowa City, IA 52242

Arch Dermatol. 1984;120(10):1279-1280.

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In Reply.—

Professor Grosshans is correct when he includes median raphe cysts in the differential diagnosis of cystic lesions on the penis. Median raphe cysts, however,

Formalin-fixed transmission electron microscopy (x 12,000). S indicates secretory granules. are lined by pseudostratified columnar epithelium or keratinizing epithelium,^1,2 not by the secretory epithelium seen in this case. If one more closely examines the histologic picture of the case reported, a cyst lining of elongated cells with abundant eosinophilic cytoplasm and apparent decapitation secretion is seen. On hematoxylin-eosin staining, one is able to see a suggestion of secretory granules that are found to be PAS positive and diastase resistant. Closer examination discloses a small amount of pigment within these cells, which does not stain as melanin or hemosiderin and most likely represents lipochrome.³ These light-microscopic features may be seen in apocrine hidrocystoma,⁴ but not in median raphe cysts. Electron microscopy has been subsequently . . . [Full Text PDF of this Article]

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