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‘Sebaceous’ (epidermoid) cysts and steatocystoma multiplex


The classical ‘sebaceous’ cyst is an epidermal structure; strictly, it should be referred to as an epidermoid cyst, and it is discussed in Chapter 52 . However, true sebaceous cysts occur as so-called steatocystoma multiplex, a naevoid condition that histologically shows a mixture of a keratinizing epithelium and sebaceous lobules attached to the epidermis by a thin epidermal strand [1–3] . A recent clinical and histological study examined 64 sporadic cases with an average age of onset of 26 years. They confirmed the presence of multiple, smooth, elastic, yellow dermal swellings varying from a few millimetres to 20 mm in size ( Fig. 42.89 ) distributed on the arms, chest, neck and axillae and appearing and/or enlarging at puberty. Lesions are known to last indefinitely, and whether they resolve with old age is uncertain. Inflamed lesions due to rupture of the cysts are common and, when extensive, can produce the so-called steatocystoma multiplex suppurativa, which mimics acne conglobata. Steatocystoma multiplex (SM) shares many clinical features and may show overlapping histopathological features with eruptive vellus hair cyst (EVHC). In this series of 64, all cases exhibited eosinophilic cuticle and lack of granular layer, and 17–42% displayed vellus hair, hair follicles, keratin, and smooth muscle components within the cavity, in the wall, or adjacent to it. The results of this ... log in or subscribe to read full text

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