ABSTRACT
Tinea of vellus hair is caused by dermatophyte infection of vellus hairs, and commonly affects children. It usually occurs on the face, and clinically manifests as annular or semi-annular erythema gradually spreading to the surrounding area, with central clearing and a slightly elevating border covered with papules and papulovesicles. Intense inflammation, which may manifest as pustules, erosions, exudation, scales and crusts, can be observed in patients with severe tinea of vellus hair. Direct microscopy of fungi showed abundant hyphae and/or spores on vellus hairs. Topical antifungal therapy is usually ineffective, and systemic antifungal therapy should be considered. In order to reduce the high rate of missed diagnosis and misdiagnosis, and to improve clinicians′ understanding of this disease, this review summarizes the incidence, clinical manifestations, diagnosis and treatment of tinea of vellus hair.
ABSTRACT
Abstract Tinea incognito resulting from corticosteroid abuse is becoming very common in the tropics. Its diagnosis is tricky owing to its confusing morphology, as well as practical and technical issues associated with mycological tests. Dermoscopy has now evolved as a novel diagnostic tool for diagnosing tinea incognito in such challenging situations, since the typical hair changes such as Morse-code hairs, deformable hairs, translucent hairs, comma and cork screw hairs, and perifollicular scaling may be seen despite steroid use, irrespective of mycological results.
Subject(s)
Humans , Male , Young Adult , Tinea/pathology , Tinea/diagnostic imaging , Dermoscopy/methods , Tinea/etiology , Adrenal Cortex Hormones/adverse effects , Hair/pathologyABSTRACT
Eruptive vellus hair cysts (EVHCs) are small, red- or brown-colored cystic papules that usually occur on the chest and proximal extremities of children and adults. Histologically, these small cysts are observed in the mid-dermis and contain multiple hair shafts and keratinous material. Pathogenesis of EVHC has not been completely understood. A 40-year-old man with mental retardation presented with multiple bluish papules on his back. A biopsy specimen showed features of eruptive vellus hair cysts. We report a case of EVHC that occurred at an unusual site in a patient with mental retardation.
Subject(s)
Adult , Child , Humans , Biopsy , Extremities , Hair , Intellectual Disability , ThoraxABSTRACT
Los quistes vellosos eruptivos se presentan como lesiones de 1 a 4 mm, aspecto papular, color piel, rojizo a amarillento de etiología desconocida, localizados en tórax anterior o extremidades, con menor frecuencia pueden observarse en cara, cuello, abdomen y glúteos. Representan una patología poco frecuente derivada del infundíbulo piloso que puede ocurrir esporádicamente o ser heredada de forma autosómica dominante. Aunque su principal importancia radica en el diagnóstico diferencial, la dificultad en el manejo terapéutico es otro reto en esta entidad. Se presenta un caso de quistes vellosos eruptivos con compromiso extenso en el cual consideramos de interés peculiar, la localización facial.
Eruptive vellus hair cysts are papular lesions of 1-4 mm, skin color, reddish to yellowish, of unknown etiology, located on anterior chest or extremities. Less frequent locations may be seen on face, neck, abdomen and buttocks. It is an unusual condition resulting from hair infundibulum that may occur sporadically or being inherited in autosomal dominant manner. Although its main importance lies in the differential diagnosis, therapeutic approach is another challenge in this entity. A case of eruptive vellus cyst with extensive involvement is presented, emphasizing facial location of the lesions.
Subject(s)
Humans , Female , Young Adult , Cysts , Epidermal Cyst , Skin Diseases , Acne Vulgaris , CauteryABSTRACT
PURPOSE: Eruptive vellus hair cysts (EVHC) are benign lesions that affect the pediatric population and are rarely seen congenitally or in young adults. EVHCs are small, cystic papules that usually occur on the chest and proximal extremities. EVHCs of the eyelids have been reported infrequently. We experienced a case of solitary EVHC that developed on the eyelid in a middle-aged male. Herein, we present our case with a brief review of the literature. CASE SUMMARY: A 44-year-old male presented with a history of an asymptomatic, palpable mass in the right upper eyelid that had been slowly growing for 2 years. Physical examination revealed non-tender, firm and round mass in right upper eyelid. Computed tomography scan of the orbit showed a 7.0 x 9.0 x 9.5 mm-sized focal bulging contour in the right upper eyelid. The patient underwent sub-brow incision and excisional biopsy of the eyelid mass. Histopathological examination revealed a 7.0 x 6.0 x 4.0 mm-sized cystic structure lined by squamous epithelium containing laminated keratinous materials and multiple vellus hair shafts. There was no local recurrence during the postoperative follow-up. CONCLUSIONS: We experienced a rare case of EVHC that developed on the eyelid. Based on our experience, EVHC should be considered when determining an eyelid mass, especially around hair follicles.
Subject(s)
Adult , Humans , Male , Young Adult , Biopsy , Epithelium , Extremities , Eyelids , Follow-Up Studies , Hair Follicle , Hair , Orbit , Physical Examination , Recurrence , ThoraxABSTRACT
A nevus with cyst is defined as a single lesion of a melanocytic nevus, and this is commonly associated with an epidermal cyst. There have been rare reported cases of adnexal origin. The combination of nevus and cyst could possibly be misdiagnosed clinically as a malignant melanoma at initial examination. A 51-year-old woman presented with a painful, solitary, dome-shaped, erythemaous nodule on the forehead which had been present for several years. The histopathologic specimen of the nodule showed a solitary cyst with a melaocytic nevus. There were nevus cells without junctional activities in the upper dermis and melanin pigments in the upper dermal nevus nest. It contained lamellated keratin materials and vellus hair shafts. We report here a rare case of melanocytic nevus combined with an vellus hair cyst in a 51-year-old woman.
Subject(s)
Female , Humans , Middle Aged , Bone Cysts , Dermis , Epidermal Cyst , Erythema , Forehead , Hair , Melanins , Melanoma , Nevus , Nevus, PigmentedABSTRACT
BACKGROUND: Triangular alopecia, previously known as temporal or congenital triangular alopecia, is a kind of alopecia typically observed in infants and children. Triangular alopecia is rarely reported, and little is known about its histopathology and response to treatment. OBJECTIVE: To describe the clinical and histopathological features, as well as response to treatment of triangular alopecia in Korean patients. METHODS: A total of 15 patients, diagnosed at our department from 2000 through 2012, were evaluated. RESULTS: All patients were presented with a triangular or oval, skin colored hairless patches on the frontotemporal sutureline, except one patient who had hairless patch on the occipital sutureline. Average age of onset was 4.13 years old and there was no sexual predilection. The histopathologic features were similar in all patients with a few vellus hairs, no terminal hair and without any abnormalities at the epidermis and dermis. Ten out of 15 patients were treated with topical minoxidil solution and 2 patients showed mild improvement. CONCLUSION: Some cases of triangular alopecia are recognized at birth; however, other cases appear to develop during the first three or four years of life. These later development can be best explained as a result of hair miniaturization leading to vellus hair formation.
Subject(s)
Child , Humans , Infant , Age of Onset , Alopecia , Dermis , Epidermis , Hair , Miniaturization , Minoxidil , SkinABSTRACT
Eruptive vellus hair cysts (EVHC) are characterized by multiple, small, discrete red or brown colored papules that usually occur on the chest and extremities. Their etiology is unknown. A variant form of EVHC that occur exclusively on the face is rare and it is very characteristic for its location and color. We report here on a facial variant of EVHC that occurred on the face of 23-year-old woman with asymptomatic, skin-colored to bluish tiny papules. The lesions first appeared at the age of 22-years.
Subject(s)
Female , Humans , Young Adult , Extremities , Hair , ThoraxABSTRACT
Eruptive vellus hair cyst (EVHC) is a benign epithelial tumor. Clinically, it usually presents as grouped or scattered yellowish to reddish-brown papules. It predominantly appears on the anterior part of the chest and extremities. Facial involvement is uncommon and 4 cases with facial involvement have been reported in the Korean dermatologic literature. However, involvement of the face coexistent with involvement of the trunk and extremities has never been reported in the Korean dermatologic literature. Herein, we report on a 10-year-old girl with multiple asymptomatic papules on her face, back and upper arms. To the best of our knowledge, this is the first report of EVHC that involves not only the face, but also the trunk and extremities in the Korean dermatologic literature.
Subject(s)
Child , Humans , Arm , Extremities , Hair , ThoraxABSTRACT
Eruptive vellus hair cysts are asymptomatic, flesh-colored- to-bluish, 1-to-4 mm-sized papules that are usually located on the chest and extremities of children and young adults. Histologically, small cysts are observed in the mid-dermis and these cysts contain multiple hair shafts and keratinous materials. We report here on a case of eruptive vellus hair cysts that developed on a rare site, the labium major.
Subject(s)
Child , Humans , Young Adult , Extremities , Hair , Keratins , ThoraxABSTRACT
A 28-year-old woman presented with multiple, asymptomatic, erythematous to bluish papules located on the chest. Histopathologically, three round, well defined cystic structures were seen on the upper and lower dermis. The first cyst was milia, the second was apocrine hidrocystoma and the other, largest cyst was an eruptive vellus hair cyst (EVHC). A diagnosis of multiple pilosebaceous cysts combined with apocrine hidrocystoma was made. Since the milia and EVHC originate from the pilosebaceous unit, and the apocrine duct opens to the pilosebaceous orifice, we suggest that they can occur simultaneously in the same unit.
Subject(s)
Adult , Female , Humans , Biopsy , Dermis , Hair , Hidrocystoma , ThoraxABSTRACT
Eruptive vellus hair cysts are yellowish or reddish-brown and are grouped or scattered papules with a smooth or crusted surface. The cysts occur predominantly over the anterior part of the chest, extremities and axillae, although they can also be seen on the neck and groin and may range from a single lesion to hundreds. Lesions have rarely been reported to regress spontaneously, so patients request treatment for cosmetic reasons. Few case reports exist on therapy for eruptive vellus hair cysts. It is known that therapies can lead to unsatisfying results or recurrences. We report a case of an eruptive vellus hair cyst successfully treated by mini-incision.
Subject(s)
Humans , Axilla , Extremities , Groin , Hair , Neck , Recurrence , ThoraxABSTRACT
The combination of melanocytic nevus with other tumors of epidermal or adnexal origin has been described since the first case reported by Andresen and Enos in 1952. Most of reported cases are melanocytic nevi combined with common epidermoid cysts. The combination of nevus and cyst could possibly be misdiagnosed clinically as a malignant melanoma upon initial examination. A 58-year-old woman presented with an asymptomatic, solitary, skin-colored, erythematous 1.0 cm-diameter pedunculated nodule on the occipital scalp which had been present childhood. The histopathologic specimen of the nodule showed a solitary cyst surrounded by intradermal melanocytic nevus. The cyst was located in the dermis lined by squamous epithelium, which was ruptured and inflamed. It contained degenerated keratin materials and multiple transversely and obliquely cut vellus hairs. We herein report a rare case of melanocytic nevus combined with a vellus hair cyst.
Subject(s)
Female , Humans , Middle Aged , Bone Cysts , Dermis , Epidermal Cyst , Epithelium , Hair , Melanoma , Nevus , Nevus, Pigmented , ScalpABSTRACT
We report a case of solitary vellus hair cyst on the forehead in a 48 year-old, female patient. She had an asymptomatic, solitary, bluish, 0.3x0.3cm sized papule on the forehead for 1 year. There was no family history of similar lesions. A punch biopsy specimen taken from the papule revealed a cystic structure in the dermis lined by squamous cell epithelium which contained laminated keratinous material and vellus hairs. Based on this histologic finding, we diagnosed this case as solitary vellus hair cyst occurring on the unusual site of the forehead.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Dermis , Epithelium , Forehead , HairABSTRACT
An eruptive vellus hair cyst is an uncommon, benign, epithelial tumor with hair differentiation. Clinically, it presents as asymptomatic, flesh-colored to yellowish, follicular papules, 1 to 4 mm in diameter, most commonly on the chest. It is usually seen in children and young adults but may be congenital. Histologically, it shows a middermal cyst lined by squamous epithelium containing keratinous material and vellus hairs. It has a tendency to clear spontaneously but may be persistent. We report a case of congenital eruptive vellus hair cyst in an 11-year-old girl who presented multiple pinhead-sized brown to black papules on her anterior chest since birth.
Subject(s)
Child , Female , Humans , Young Adult , Epithelium , Follicular Cyst , Hair , Parturition , ThoraxABSTRACT
Eruptive vellus hair cysts are characterized by asymptomatic, skin colored to bluish, or brownish, 1-4mm sized, follicular papules and nodules located on mainly anterior chest, axilla, groin, and thigh. Histopathologic examination reveals cysts containing multiple vellus hairs and the laminated keratinous materials at dermis. We reported 2 cases of eruptive vellus hair cysts developed on the unusual sites, forehead and buttock, respectively.
Subject(s)
CystsABSTRACT
We report a 48-year-old female who had eruptive vellus hair cysts associated with milia on the face. Histopathologic examination of lesions on the forehead and cheek showed typical findings of eruptive vellus hair cysts and milia. These findings suggested that two entities are in some way related. Eruptive vellus hair cysts and milia can be considered as subtypes of multiple pilosebaceous cysts that may all present overlapping histologic features.
Subject(s)
Female , Humans , Middle Aged , Cheek , Forehead , HairABSTRACT
Eruptive vellus hair cysts(EVHCs) are small, red or brown colored cystic papules that usually occur on the chest and proximal extremities of children and adults. Although EVHCs, facial variant, is rare and chracteristic in its location and color, histopathological findings of facial variant are not different from those of typical EVHC. We report a case of EVHC, facial variant which occured on the face of 23-year-old man with asymptomatic, bluish papules. The lesions first appeared at the age of 19 years and had increased in number thereafter.
Subject(s)
Adult , Child , Humans , Young Adult , Extremities , Hair , ThoraxABSTRACT
Eruptive vellus hair cyst and steatocystoma multiplex are two clinically similar conditions. Most cases can be differentiated by histological examination. However, in some patients overlapping histological features have been described. We present herein a 23-year-old man with combined eruptive vellus hair cyst and steatocystoma multiplex. Histopathologically, the cyst shows feature of steatocystoma multiplex and eruptive vellus hair cyst simultaneously. This case suggests that eruptive vellus hair cyst and steatocystoma multiplex are within the same spectrum of the disease process.