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Ghosh Moulic A, Deshmukh P, Gaurkar SS. A Facial Solitary Vellus Hair Cyst: A Rare Entity. Cureus 2024; 16:e54159. [PMID: 38496162 PMCID: PMC10940956 DOI: 10.7759/cureus.54159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
This case report details a rare occurrence of a vellus hair cyst presenting as a recurrent nodular swelling on the medial aspect of the right eye in a 23-year-old male. The patient underwent surgical excision guided by imaging studies, and the subsequent two-month follow-up revealed no signs of recurrence. Imaging, including contrast-enhanced computer tomography (CECT), played a crucial role in assessing the extent of the lesion and ruling out intracranial involvement. Histopathological examination confirmed the diagnosis, revealing cystic spaces with an attenuated lining containing vellus hair and marked fibrosis. The case underscores the importance of considering uncommon entities in differential diagnoses, emphasizes the efficacy of complete cyst removal in preventing recurrence, and contributes to the evolving understanding of vellus hair cysts. Further research is warranted to enhance our knowledge of their epidemiology and optimal management strategies.
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Affiliation(s)
- Ayushi Ghosh Moulic
- Otolaryngology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prasad Deshmukh
- Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sagar S Gaurkar
- Otolaryngology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Chughtai A, Hashim MMA, Saleem R, Zafar G, Yasin R, Chughtai O, Chughtai AS, Zafar A. Benign Cutaneous Cysts: A Comprehensive Analysis of 1160 cases. Cureus 2023; 15:e45548. [PMID: 37868536 PMCID: PMC10586350 DOI: 10.7759/cureus.45548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Background Cysts are common skin abnormalities that are mostly benign; however, sometimes malignant lesions may present clinically as cystic manifestations. Benign cutaneous cysts can be of different morphological types and their diagnosis relies on histological evaluations. The most common mode of treatment is surgical excision, which is curative. Methodology This is a retrospective cross-sectional study conducted at the Department of Histopathology, Chughtai Institute of Pathology, Lahore, Pakistan from 1st January 2020 to 31st December 2022. Non-probability consecutive sampling was done, and all the cases of benign cutaneous cysts were included. All cases were microscopically reviewed by two histopathologists, and variables like age, gender, site of the lesion, and histological diagnosis were noted. The data were analyzed using IBM SPSS Statistics for Windows, Version 29 (Released 2022; IBM Corp., Armonk, New York, United States). Results A total of 1160 recorded cases of benign cutaneous cysts were included. Overall gender distribution revealed males (n=489, 42.1%) and females (n=671, 57.8%). The age range was 3 to 91 years with a mean age of 37.56 ± 16.05 years. The three most common cysts were epidermal inclusion cysts (74.3%), trichilemmal cysts (15.1%), and dermoid cysts (6.3%). Other cysts were uncommon including hidrocystoma (1.9%), steatocystoma (0.3%), verrucous cysts (0.3%), comedones (0.6%), hybrid cysts (0.2%), milia (0.3%), and vellus hair cysts (0.2%). The most common site was back (23.5%) for epidermal inclusion cysts, scalp (74.4%) for trichilemmal cysts, and eye (33.8%) for dermoid cysts. Conclusion Benign cutaneous cysts have a broad morphological spectrum with a wide age range. Epidermal inclusion cysts, trichilemmal cysts, dermoid cysts, and hidrocystoma account for the four most common types. For each of the other cyst type, the prevalence was under 1%. Female gender predominated in epidermal inclusion cysts, trichilemmal cysts, and dermoid cysts while male gender was common in other cysts. Overall majority of the cysts presented in the head and neck area.
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Affiliation(s)
- Anila Chughtai
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | | | - Rashida Saleem
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | - Ghazi Zafar
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | - Rafeya Yasin
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | - Omar Chughtai
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | | | - Asma Zafar
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
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Muskat A, Shokrian N, Kost Y, Srivastava P, Amin B, McLellan BN. A novel case of eruptive vellus hair cysts arising during radiation therapy and a brief review of the literature. Acta Oncol 2023; 62:58-61. [PMID: 36649204 DOI: 10.1080/0284186x.2023.2167525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Ahava Muskat
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Neda Shokrian
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yana Kost
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Pooja Srivastava
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Bijal Amin
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Beth N McLellan
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Kamyab K, Kianfar N, Dasdar S, Salehpour Z, Nasimi M. Cutaneous cysts: a clinicopathologic analysis of 2,438 cases. Int J Dermatol 2020; 59:457-462. [PMID: 32034771 DOI: 10.1111/ijd.14808] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 12/01/2019] [Accepted: 01/12/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Benign cutaneous lesions, so-called cysts, are frequently seen in clinics and might evoke cosmetic and psychosocial concerns. AIM This study aimed to demonstrate the clinicopathologic findings of these lesions and also the importance of histological evaluation for prevention of misdiagnosing a benign-appearing malignant lesion. METHODS A descriptive study was conducted of 2,438 cases who had a diagnosis of cyst confirmed with pathology. The data of patients over the 6-year period between 2011 and 2017, including gender, age, location, prevalence, complications, and microscopic evaluation, were gathered. RESULTS From a total of 2,438 records with a clinical diagnosis of mucocutaneous cyst, 2077 had the pathologic diagnosis of cysts. They consisted of 910 women (43.8%) and 1167 men (56.1%) with a mean age of 42. The most common mucocutaneous cysts were epidermal cyst 994 (47.8%) followed by trichilemmal cyst 495 (23.8%). In 479 (19.6%) records, the clinical diagnosis was not congruent with histopathological diagnosis including 45 malignant cases. Basal cell carcinoma in 22 (48.9%) was the most common one. CONCLUSIONS This study reports on clinical characteristics of cutaneous cysts and the need for a decent diagnostic investigation, like histopathology, for achieving a reliable diagnosis regarding the benign mimicking malignant lesions, especially high risk ones.
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Affiliation(s)
- Kambiz Kamyab
- Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nika Kianfar
- Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Maryam Nasimi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Chen YY, Lan CCE. Eruptive vellus hair cysts in an unusual location with atypical pathological features. Kaohsiung J Med Sci 2018; 34:310-311. [PMID: 29699640 DOI: 10.1016/j.kjms.2017.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/26/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yang-Yi Chen
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Che E Lan
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Daulatabad D, Grover C, Sharma S. ‘Extraction dermoscopy’ as a rapid and innovative diagnostic tool for eruptive vellus hair cyst. Clin Exp Dermatol 2017; 42:438-440. [DOI: 10.1111/ced.13096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2016] [Indexed: 11/29/2022]
Affiliation(s)
- D. Daulatabad
- Department of Dermatology; University College of Medical Sciences and Guru Teg Bahadur Hospital; Dilshad Garden Delhi, 110095 India
| | - C. Grover
- Department of Dermatology; University College of Medical Sciences and Guru Teg Bahadur Hospital; Dilshad Garden Delhi, 110095 India
| | - S. Sharma
- Department of Pathology; University College of Medical Sciences and Guru Teg Bahadur Hospital; Dilshad Garden Delhi, 110095 India
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A Tale of Two Cysts: Steatocystoma Multiplex and Eruptive Vellus Hair Cysts—Two Case Reports and a Review of the Literature. Case Rep Dermatol Med 2017; 2017:3861972. [PMID: 28480085 PMCID: PMC5396452 DOI: 10.1155/2017/3861972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/16/2017] [Indexed: 11/23/2022] Open
Abstract
Background. Steatocystoma multiplex (SM) and eruptive vellus hair cysts (EVHC) are uncommon benign tumors of the pilosebaceous unit. Both SM and EVHC are characterized by smooth, asymptomatic papules or nodules, most commonly presenting on the chest, limbs, and abdomen. Most cases of SM and EVHC are sporadic, although less common autosomal dominant inherited forms have been reported. Main Observation. In this report we present two cases of cutaneous cysts exhibiting characteristics of either SM or EVHC. Both patients presented with numerous 1-2 mm asymptomatic papules and responded well to surgical expression by incision and drainage (I&D). Conclusion. SM and EVHC are similar in clinical presentation and management. Previously reported “hybrid-type” tumors present strong evidence for a relationship between the two lesions pathologically. Due to potential similarity of EVHC and SM cyst contents, I&D and subsequent microscopic examination cannot definitely differentiate between EVHC, SM, and hybrid cysts.
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Alfaro-Castellón P, Mejía-Rodríguez SA, Valencia-Herrera A, Ramírez S, Mena-Cedillos C. Dermoscopy distinction of eruptive vellus hair cysts with molluscum contagiosum and acne lesions. Pediatr Dermatol 2012; 29:772-3. [PMID: 22639880 DOI: 10.1111/j.1525-1470.2012.01771.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Eruptive vellus hair cysts are benign lesions that can be difficult to distinguish from other skin conditions, including molluscum contagiosum and acne vulgaris. Diagnosis can be corroborated with histopathology. We emphasize differing dermoscopy features to help distinguish eruptive vellus hair cysts from molluscum contagiosum or acne.
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Zaharia D, Kanitakis J. Eruptive vellus hair cysts: report of a new case with immunohistochemical study and literature review. Dermatology 2012; 224:15-9. [PMID: 22456201 DOI: 10.1159/000337209] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 01/31/2012] [Indexed: 11/19/2022] Open
Abstract
Eruptive vellus hair cysts (EVHC) are rather uncommon lesions, of which 222 cases have been published in the literature. Their etiopathogenesis is poorly known. We report herein a new typical case of EVHC that was studied immunohistochemically. A 15-year-old male presented with a 4-year history of progressively developing small brown-gray papules on the trunk and extremities. Microscopically the lesions consisted of small epidermoid cysts containing vellus hairs. Immunohistochemically, the lesions expressed keratin 1/10, calretinin and p63 but no epithelial membrane antigen, filaggrin or androgen receptors. A review of the relevant literature shows that EVHC may be inherited or acquired and may be associated to other genodermatoses, namely sebocystomatosis. They could be due to hamartomatous follicular growth, to a trouble in infundibular keratinization leading to vellus hair follicle occlusion, or represent an example of acquired hamartoma. Although benign, this condition is difficult to treat.
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Affiliation(s)
- Daniela Zaharia
- Department of Dermatology and Laboratory of Dermatopathology, Edouard Herriot Hospital Group, Lyon, France
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Abstract
We report the results of the first systematic review of the worldwide literature on eruptive vellus hair cysts (EVHC). It is likely that EVHC are less rare than it may appear from the scarcity of related publications in the literature. EVHC may be present at birth and may appear at any age, although they show a clear trend towards occurring during the first 3 decades of life. A strong clue to the heavy influence of genes on the occurrence of EVHC is provided by the numerous reports of families in whom two or more members were affected. EVHC lesions present clinically in a rather monomorphous fashion, i.e. round, dome-shaped, skin-colored, asymptomatic, soft-tender papules with a smooth surface and grouped or disseminated in a symmetric pattern. EVHC may affect any cutaneous area, even if the upper part of the body and some distribution patterns are particularly frequent and recognizable, i.e. cephalic, upper trunk around the midline, upper limb including axillae, and proximal lower limb. Such a distribution is likely not random and seems to grossly overlap with that of pilosebaceous and apocrine units. Like clinical morphology, the histologic features of EVHC papules are rather monomorphous, indeed, the diagnostic hallmark being the presence of vellus hair shafts within the cystic space. Peculiar subgroups (familial, late-onset, unilesional, and associated with steatocystoma multiplex) are also identified and discussed. In conclusion, EVHC are basically a cosmetic concern to patients but represent a chronic and difficult-to-treat condition. On the basis of our review, future studies are warranted, mainly concerning (i) further nosographic framing involving genetic and tissue analysis, (ii) implementation of non-invasive diagnostic procedures, and (iii) therapeutic trials of interventions shown to achieve some effectiveness.
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Affiliation(s)
- Daniele Torchia
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, FL,
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Fernández-Torres R, del Pozo J, Castiñeiras I, Sacristán F, Mazaira M, Fonseca E. Treatment of multiple eruptive vellus hair cysts with carbon dioxide laser vaporization and manual lateral pressure. Clin Exp Dermatol 2009; 34:e716-8. [DOI: 10.1111/j.1365-2230.2009.03443.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nishino M, Jacobs A, Coleman N, Reed J, Rosen T, Orengo I. A hairy problem. Am J Clin Dermatol 2008; 9:275-7. [PMID: 18572980 DOI: 10.2165/00128071-200809040-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Michiya Nishino
- Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030, USA
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