Suggestion for the treatment of steatocystoma multiplex located exclusively on the face

BACKGROUND: Although there are numerous reports of different treatment methods, the long-term management of steatocystoma multiplex remains difficult. In this article we describe a simple technique that we used to treat the cysts on the face of a patient. METHODS: A 31-year-old male with steatocystoma multiplex located on the forehead and both temples was treated by inserting the tip of a needle and extirpating the contents, without removing the cyst wall. RESULTS: The procedure was very well tolerated by the patient. There have been no complications during or following the procedure. There were no recurrences after 10 months of follow up. CONCLUSIONS: We suggest that this very simple technique is worth trying as a treatment of choice, especially for the management of facial lesions, where scarring is unacceptable.     

Successful treatment of steatocystoma multiplex by simple surgery

Steatocystoma multiplex is usually a minor cosmetic problem but rarely can be extremely disfiguring. Unfortunately, the very patients who would benefit most from treatment are usually regarded as having too may cysts for surgery. We report a case of extensive steatocystoma multiplex which was treated by a simple surgical technique under general anaesthetic.     

The use of the freer dissector for the removal of trichilemmal cysts

BACKGROUND: Trichilemmal cysts are keratin-containing cysts, usually situated on the scalp. They often show an autosomal dominant inheritance pattern. Excision is the treatment of choice. We describe a practical surgical technique that eases the removal of these cysts. METHODS: A 24-year-old woman presented with a 5-year history of cystic lesions on her scalp, clinically diagnosed as trichilemmal cysts. She was treated with the new technique. After making a small incision under local anesthesia, a freer dissector (Aesculap(R) OL 165 R) was used as a blunt dissector. The freer dissector was inserted through the incision. A blunt dissection was made to dissect the cyst free from the surrounding dermis and, by using the dissector as a lever, gentle pressure was applied to the opposite side to ease the cyst from the dermis. Four cysts were removed with this technique. RESULTS: The treatment was well tolerated by the patient. No complications developed during or after the procedure. CONCLUSIONS: This modified technique is simple and practical. The slight curve at each end of the freer dissector makes it easy to grasp the cyst and, functioning like forceps, the cyst can be eased from the dermis. We believe that the use of the freer dissector in the surgical excision of trichilemmal cysts aids and speeds up the procedure.     

CO2 laser therapy in a case of steatocystoma multiplex with prominent nodules on the face and neck

BACKGROUND: Steatocystoma multiplex is an uncommon disorder which usually begins in adolescence or early adult life. The condition can be hereditary, as an autosomal dominant trait, or nonhereditary, as in this case. METHODS: A 40-year-old woman presented with a history of asymptomatic nodules that began around puberty on the face. There was no family history of similar lesions. Clinical examination revealed multiple nodules distributed on the face and neck. The histopathologic examination of a biopsy specimen showed the typical features of steatocystoma multiplex. CO2 laser therapy without anesthesia was employed, and the contents were evacuated by squeezing the cysts with a pair of forceps. RESULTS: Very good results were obtained with rapid healing, minimal invasiveness, and without anesthesia. There was no evidence of scar formation and no signs of recurrence at 2-year follow-up. CONCLUSIONS: Different treatments have been reported for steatocystoma multiplex. We consider CO2 laser therapy to be an ideal technique for the treatment of steatocystoma multiplex, especially when the lesions are localized in aesthetically important areas.     

Steatocystoma multiplex: a quick removal technique.

A 27-year-old man with multiple lesions located on his chest and neck and diagnosed as steatocystoma multiplex desired removal of these lesions. We report a facile, fast, and successful technique for the removal of lesions of steatocystoma multiplex. Using a no. 11 blade, we incised the domes of numerous lesions and removed the cyst walls with small artery forceps. Within 1 month, the incisions healed without scarring, and after 4 months of follow-up, they had not recurred. This procedure allows the removal of many lesions of steatocystoma in a few office visits.     

Eruptive vellus hair cysts: an effective extraction technique for treatment and diagnosis

BACKGROUND: Eruptive vellus hair cysts are uncommon developmental anomalies of vellus hair follicles that are observed in young patients. Two patients were evaluated for asymptomatic flesh-coloured papules appearing on the chest, abdomen and axillae. Lesions of both patients were diagnosed histologically as eruptive vellus hair cyst, which is a disorder with no standard treatment option. OBJECTIVE: To introduce an alternative treatment and diagnostic technique for eruptive vellus hair cysts and to evaluate this technique's effectiveness histopathologically. MATERIALS AND METHODS: We treated the lesions by using cautery and a standard dissecting forceps under topical anaesthesia. After puncturing the overlying skin in the centre using the sharp-tipped cautery point, we grasped the base of the cyst using a standard dissecting forceps and we extracted the cysts out. In patient 1, extracted cysts were sent for histopathological examination; in patient 2, microscopic examination of the extracted material was performed in potassium hydroxide preparations. RESULTS: Over 150 cysts were extracted with this technique in two patients. The technique was simple, quick and tolerated well. No lesion recurrence was observed after 4 months. On histopathological examination, extracted cysts were observed to have cyst walls. In patient 2, the diagnosis was made within minutes by microscopic examination of the potassium hydroxide preparations of the extracted material. CONCLUSION: Our extraction technique is a simple and effective treatment option for these cysts. It can be regarded as curative since the cyst walls were also extracted. Microscopic examination of the potassium hydroxide preparation of the extracted cysts suggests that this technique can also be used as a simple diagnostic procedure.     

全身多发性脂囊瘤

报告1例全身多发性脂囊瘤.患者男,40岁.因全身泛发囊肿30年就诊.无家族史.组织病理检查示真皮至皮下有不规则囊腔,囊壁为复层鳞状上皮,无颗粒层,与多个皮脂腺相连接.诊断:多发性脂囊瘤.患者未接受治疗.     

Eruptive vellus hair cysts with sebaceous glands

A patient is described who had eruptive vellus hair cysts with and without sebaceous glands in the cyst walls. An association is suggested between eruptive vellus hair cysts and the condition of steatocystoma multiplex.     

Eruptive vellus hair cyst and steatocystoma multiplex: two related conditions?

Eruptive vellus hair cyst and steatocystoma multiplex are infrequent lesions. Although there are clinical similarities between both entities, histologic features are distinctive. Especially noteworthy is the presence of sebaceous glands within the cyst wall of steatocystoma. We describe herein a patient with a familial monomorphous papular eruption on the forehead, biopsies from which showed features of both eruptive vellus hair cyst and steatocystoma multiplex.     

Multiple pilosebaceous cysts

We report two patients initially diagnosed as having steatocystoma multiplex (SM), Other cysts showed characteristics of eruptive vellus hair cyst (EVHC). More than 30 and 14 cysts, respectively, were removed with histological hybrid characteristics of SM and EVHC. This suggests that SM and EVCH are two closely related entities, which represent a naevoid malformation in the area where the sebaceous duct and hair follicle meet.     

Echographic evaluation of nodular lesions of the skin

Echographic differentiation between clinically similar, nodular lesions of the dermis and subcutaneous fat was done in an attempt to open a new field of ultrasonic histopathology. Sector B-mode echography with a 10 MHz transducer was done on 87 patients with nodular lesions in the dermis and subcutaneous fat, and the echograms were compared with microscopic findings. These consisted of nevus pigmentosus in 10, neurofibroma in 10, steatocystoma multiplex in 4, epidermoid cyst in 30, cavernous hemangioma in 4, lipoma in 10, panniculitis in 14 and malignant lymphoma in 5 patients. Neurofibroma and steatocystoma multiplex were as echolucent as lipoma, while nevus pigmentosus and epidermoid cyst were less echolucent. Small internal echoes were observed within the echolucent mass in 15 of 30 lesions of epidermoid cysts. Cavernous hemangioma, panniculitis, and malignant lymphoma were partially echogenic as well as echolucent.     

Eruptive steatocystoma multiplex on the scalp.

We report a 71-year-old Japanese woman who noticed approximately 120 small yellowish cysts on the scalp from nine months before her first visit. An incision made into the cysts discharged oily yellow material. Biopsy of a lesion disclosed that the cysts had typical features of steatocystoma multiplex histologically. This case was a unique eruptive variety of steatocystoma multiplex on the scalp.     

Steatocystoma multiplex suppurativum: treatment with isotretinoin

A patient with steatocystoma multiplex with multiple ruptured draining cysts and abscesses was treated with a twenty-week course of isotretinoin. Abscesses involuted and inflamed cysts shrank. The remission persisted for ten weeks after discontinuing therapy; subsequently cysts and abscesses occurred in multiple sites.     

Fractionated ablative carbon dioxide laser treatment of steatocystoma multiplex

Steatocystoma multiplex is a well-recognized condition in which subjects develop dermal cysts generally inherited in an autosomal dominant fashion, though these can occur sporadically. This case report describes the successful treatment of a 51-year-old woman with steatocystomata limited to the face, who after two treatments with a fractionated ablative carbon dioxide laser remained free of cysts for three years. We conclude that this treatment should be considered as an efficient and effective treatment option for patients with steatocystoma multiplex.     

Eruptive vellus hair cysts and steatocystoma multiplex. Variants of one entity?

Summary Eruptive vellus hair cysts and steatocystoma multiplex are two clinically similar conditions which show multiple papules and nodules, mainly located over the anterior chest wall. Most cases can be differentiated on histological examination, but in some patients overlapping histological features have been described. We present a patient who showed features of both entities and interpret this as suggesting that eruptive vellus hair cysts and steatocystoma multiplex are variants of one disorder which originates in the pilosebaceous duct.     

Steatocystoma multiplex. Report of a florid case and a review.

A patient had numerous cysts over almost all of his skin surface. The lesions were persistently infected, painful, and odorous, and were contributory to the patient's psychological problems. The cysts were histologically determined to be of the steatocystoma multiplex variety. Several therapeutic modalities were used but only surgical incision, drainage, and electrocautery were beneficial.     

A Case of Steatocystoma Simplex Involving the Scalp

Steatocystoma is a benign adnexal tumor originating from the pilosebaceous duct junction which can be classified into two groups (steatocystoma simplex and steatocystoma multiplex). Steatocystoma simplex, which presents as a solitary lesion, is very rare. Steatocystoma simplex occurs most commonly on the face and the case reported herein involving the scalp is extremely rare. A 49-year-old man presented for evaluation and treatment of a solitary papule on the right parietal scalp which had persisted for a period of 1 year. The histopathologic examination revealed a thin-walled cyst consisting of stratified squamous epithelium with hyaline cuticle that lacked a stratum granulosum. Based on clinical and histologic findings, we diagnosed this case as steatocystoma simplex of the scalp and report this rare case.     

Follicular hybrid cysts. An expanded spectrum.

Currently it is well established that each of the three parts of the hair follicle (infundibulum, isthmus, and the inferior portion) originates different types of cutaneous cysts. Thus, follicular cysts include infundibular, trichilemmal, and matricial cysts. Brownstein in 1983 described a mixed type of cutaneous cyst combining epidermoid, infundibular, and trichilemmal types of keratinization. We review and illustrate the different combinations of follicular hybrid cysts reported to date: infundibular and trichilemmal cyst, infundibular and pilomatricoma cyst, trichilemmal and pilomatricoma cyst, eruptive vellus hair cyst and steatocystoma, and eruptive vellus hair cyst and trichilemmal cyst. Therefore, the concept of hybrid cyst should not be restricted to those composed of infundibular and trichilemmal cysts, because any cyst arising from the various parts of the pilosebaceous unit can combine with others to form a large series of follicular hybrid cysts.     

Treatment of steatocystoma multiplex and pseudofolliculitis barbae with isotretinoin

A 20-year old man with steatocystoma multiplex and pseudofolliculitis barbae was treated unsuccessfully with oral isotretinoin. Consistent with findings from previous reports, treatment with isotretinoin should be reserved for patients with steatocystoma multiplex suppurativum.