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 cysts.

Umbilicated and nonumbilicated papules were present on the presternal area of a patient with eruptive vellus hair cysts. Histopathological examination of umbilicated papules showed penetration of vellus hairs through cyst walls, surrounding granulomatous foreign body reaction, and communication to the surface of the skin with released vellus hairs present in the pore. This suggests that resolution of some of the cysts in this disorder may occur by transepithelial elimination.     

发疹性毳毛囊肿1例

患者女,40岁。前胸部出现丘疹2年,无自觉症状。皮损为直径2～4mm的丘疹,呈肤色。皮损组织病理示:真皮内见囊肿样结构,囊壁为复层鳞状上皮,囊内见多个毳毛横断面或斜断面。诊断:发疹性毳毛囊肿。     

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.     

Eruptive vellus hair cyst and epidermoid cyst in a patient with pachyonychia congenita

We report the first case of pachyonychia congenita (PC) associated with both eruptive vellus hair cyst (EVHC) and epidermoid cyst. The patient is a 12-year-old Japanese girl who presented with two natal teeth at birth. She had thickening and discoloration of the fingernails and toenails, plantar hyperkeratosis, palmar-plantar hyperhidrosis and multiple cutaneous cysts. Histologic examination revealed EVHC and epidermoid cyst.     

Eruptive Vellus Hair Cysts: Case Report and Review of the Literature

A 6-year-old Caucasian girl had dozens of asymptomatic, flesh-colored, 2- to 5-mm eruptive vellus hair cysts. These papules on the buttocks, thighs, and groin increased in number for three months. Histologic examination revealed poorly defined, keratin-filled cysts in the upper middermis, containing numerous transversely or obliquely cut portions of vellus hair. The histopathologic differential diagnosis with other epithelial cysts containing hair shafts is debated, and new clinical differential diagnoses are proposed. Review of the literature suggests that eruptive vellus hair cyst is not a rare disorder, but its frequency is probably underestimated due to paucity of symptoms. Nevertheless, the clinical relevance of some of the differential diagnoses should convince clinicians to obtain histologic confirmation.     

Eruptive vellus hair cysts

A 20-year-old man presented with multiple, asymptomatic, follicular papules that were distributed over his abdomen. Microscopic examination showed classic features of a vellus hair cyst. The term eruptive vellus hair cysts refers to a benign condition, which may be inherited or acquired. Apart from occasional pruritus, cosmetic disability is the chief concern of most patients. An estimated 25 percent of lesions remit spontaneously; however, treatment of persistent lesions is often challenging with disappointing results.     

Hair shafts in epidermoid cysts

17 cases of epidermoid cysts with vellus hairs in their lumen are reported. The clinical diagnosis was usually cysts. In 12 cases the lesions were solitary and in 5 they were multiple, small and closely set. Microscopically, the findings of the wall were those of the epidermoid cyst containing in their lumen hair shafts of lanugo size. The solitary variety of these cysts can be considered as the solitary counterpart of the eruptive vellus hair cyst. Problems of differential diagnosis are discussed.     

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.     

Eruptive vellus hair cysts in a patient with Lowe syndrome

We present a 20-year-old patient with Lowe syndrome and eruptive vellus hair cysts. Also known as oculocerebrorenal syndrome, it is an X-linked recessive disorder localized to Xq24-26.1. The phenotypic features of this disorder are Fanconi-type renal failure, mental retardation, and various eye abnormalities. The causative gene, oculocerebrorenal-Lowe 1 (OCRL1), encodes a phosphatase whose function is to regulate the phosphatidylinositol pool of intracellular signaling molecules that regulate the release of lysosomal enzymes in tissues. Low levels of this phosphatase lead to the extracellular release of lysosomal enzymes in organs such as the eye, brain, and kidney, with the resulting tissue damage most likely accounting for the characteristic phenotype. Our patient with Lowe syndrome had several discrete, dome-shaped papules on his midchest. They clinically resembled either eruptive vellus hair cysts or steatocystoma multiplex. Histologically they were most diagnostic of eruptive vellus hair cysts, which are not a known feature of Lowe syndrome. We present a hypothesis based on the known biochemical deficiencies resulting from the mutations in the OCRL1 gene, which may account for the cyst formation. To our knowledge, this is the first reported case of skin findings associated with this disorder.     

A simple surgical technique for the treatment of steatocystoma multiplex

BACKGROUND: Since steatocystoma multiplex is an uncommon disorder, its treatment has not been discussed in detail in the textbooks and surgical excision is the most commonly mentioned method. In this article, we describe a very simple surgical technique, which was developed by modifying previous reports. METHODS: A 29-year-old woman, diagnosed clinically and histologically as steatocystoma multiplex, was treated with this modified technique. We punctured the cysts under local anesthesia with a sharp-tipped cautery point and evacuated the contents by squeezing the cyst with a fine forceps. Then, the cyst wall was grasped by the forceps and the sacs were extracted through small holes. More than 50 cysts were treated. RESULTS: The treatment was well tolerated by the patient. No complications developed during or after the procedure. After 14 months follow up no recurrences were observed and the results were cosmetically excellent. CONCLUSIONS: This modified technique is very simple and time saving. Its cosmetic and long-term results are successful. We believe that it must be considered as the treatment of choice for steatocystoma multiplex.     

Eruptive vellus hair cyst in patients with chronic renal failure

Two cases of eruptive vellus hair cysts associated with chronic renal failure are reported. Histologically the lesions of both cases showed cystic structures in the dermis lined by squamous epithelium which contained varying amounts of vellus hair shafts. Immunohistochemical studies using monoclonal anti-AGE (advanced glycation end product) antibody demonstrated that keratinous materials within the cystic structures were immunoreactive to the antibody, whereas those of cystic lesions (epidermal cyst, eruptive vellus hair cyst, steatocystoma multiplex, trichofolliculoma and trichilemmal cyst) seen in otherwise healthy individuals were negative. Because it has been reported that plasma and skin levels of AGE are elevated in renal failure patients, AGE-modified keratinous materials may be associated with the formation of cystic structures by stimulating the occlusion of the epithelium.     

面部发疹性毳毛囊肿

报告1例面部发疹性毳毛囊肿。患者女,35岁。面部起丘疹10余年,无自觉症状。皮损为直径2～4mm的丘疹,呈肤色或浅黄白色,泛发于面部。组织病理检查示:真皮内见囊肿样结构,囊壁为复层鳞状上皮,囊内可见板层状角质物及数个毳毛横断面或斜断面。     

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.     

Eruptive vellus hair cysts

Eruptive vellus hair cysts are an apparent developmental anomaly of vellus hair follicles that result in an asymptomatic papular eruption characteristically located on the anterior chest in young patients. A case of eruptive vellus hair cysts in reported, and the clinical and histologic findings are reviewed.     

发疹性毳毛囊肿1例

报告1例发疹性毳毛囊肿，患者女，32岁，因前额和两侧颞部起许多蓝灰色有脐窝的丘疹10余年就诊，曾误诊为汗管瘤和异物肉芽肿，组织病理为典型的发疹性毳毛囊肿。     

An alternative diagnostic method of eruptive vellus hair cysts: Report of a familial case with pruritus

Eruptive vellus hair cysts (EVHC) represent a developmental abnormality of vellus hair follicles. Up till now more than 150 cases of EVHC have been published in the literature, but it appears to be more common than recognized. The diagnostic hallmark is the presence of vellus hair shafts within the cystic space. Firstly to evaluate the potential benefit of new diagnostic method of EVHC using a dermatoscope and secondly to report a familial case of EVHC where females were only affected. Five women from the same family with a clinical diagnosis of EVHC were included in the study. The diagnosis of EVHC was confirmed by skin biopsy with histologic examination in four patients. New diagnostic approach of the cyst contents examination with using a handheld dermatoscope was performed in all patients. Numerous vellus hair shafts were detected on the images of the cysts content taken with dermatoscope and applying the above‐mentioned method in all patients. We suggest that it seems possible to differentiate EVHC by using the dermatoscope, which appears to be simple, quick, and less time consuming.     

Vellus hair cysts presenting as an atypical acneiform eruption

A 32-year-old male patient presented for 8 months an asymptomatic therapy-resistant acneiform eruption on his back and buttocks. Skin examination showed several inflammatory papules, which evolved to hyperpigmentation. At the same distribution non inflammatory papules, which resembled rice grains, were also observed. Light microscopy showed small keratin-filled cysts, with an epithelial multilayered wall, without granular layer. Keratin and some vellus hairs were identified inside the cyst, confirming the diagnosis of vellus hair cysts. Diagnosis of vellus hair cysts should be suspected in cases of multiple papules or therapy-resistant cases of acneiform eruptions.     

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.