A Inflammed Plantar Epidermal Cyst Misdiagnosed as Secondary Infection of Calluses / 대한피부과학회지

No abstract available.

A Clinical and Radiological Study on 31 Palmoplantar Epidermal Cysts / 대한피부과학회지

BACKGROUND: Epidermal cysts seldom arise on the palm or sole because of the absence of pilosebaceous apparatus in palmoplantar skin. Palmoplantar epidermal cysts (PPECs) are not included in this location's tumor category, because they appear as slightly elevated, hardly movable dermal or subcutaneous nodules without a central punctum, unlike other epidermal cysts. As a result, PPECs often mimic corns, calluses, or verruca. OBJECTIVE: The purpose of this study was to review the clinical features of PPECs and to explore the usefulness of ultrasonography as a diagnostic tool. METHODS: We retrospectively reviewed the medical records and ultrasonographic findings of 31 patients with PPECs among 341 patients with a confirmed epidermal cyst. Among them, 12 patients were evaluated preoperatively by ultrasonography. The data were compared between the ultrasonographic diagnosis and the final diagnosis. RESULTS: Unlike previous reports, PPECs were relatively common, and comprised 9.1% (31/341) of all epidermal cysts. They also appeared more on the sole than on the palm. In addition, PPECs were confused with corns, calluses, and other benign tumors at the first visit, because of their different clinical features from ordinary epidermal cysts. However, preoperative ultrasonography of 12 cases enabled us to make a correct diagnosis. After the operation, no recurrence was found at the last follow-up in any of the patients. CONCLUSION: PPECs have some different clinical features compared to typical epidermal cysts with a non- palmoplantar location. Therefore, it is often difficult to distinguish PPECs from other benign tumorous conditions. However, ultrasonography was useful for the preoperative diagnosis of PPECs because of its safety, low cost, non-invasiveness and, most importantly, its accuracy.

Demonstration of Human Papillomavirus 60 in the Palmoplantar Epidermal Cysts / 대한피부과학회지

BACKGROUND: It is generally accepted that the most spontaneously-arising epidermal cysts might be related to follicular infundibulum and palmoplantar epidermal cyst (PPEC) has been suggested to be caused from traumatic implantation of epidermal fragments. In addition there were several recent reports of human papillomavirus (HPV) implicating in formation of PPEC and also similar reports in Korean dermatologic literature. But the latter failed to reveal the presence of HPV in PPEC or a specific type of HPV by molecular biologic methods. OBJECTIVE: We tried to identify the presence of HPV and its subtype in PPEC. METHODS: After reviewing routine histopathologic findings recalling HPV infection in 8 PPECS, we undertook immunohistochemistry using polyclonal HPV antibody and polymerase chain reactions with 3 sets of HPV primers. To confirm the actual location of HPV in cyst in situ hybridization with HPV 60 probe was also done. RESULTS: All cases showed more than one feature of HPV infection. The positive reactions were 3 out of 8 on immunohistochemistry and 5 out of 8 on polymerase chain reaction. All cases (4 of 4) were positive on in situ hybridization and they were found in the horny layer and/or wall of cysts. CONCLUSION: PPEC in Korea may show similar typical histopathologic features with those reported in Japan. The HPV were detected in almost PPEC by molecular methods and their subtype was all HPV 60.

Detection of Human Papillomavirus in Palmoplantar Epidermal Cysts / 대한피부과학회지

BACKGROUND: Although traumatic implantation of epidermis into the dermis has been suggested as a possible mechanism of formation of palmoplantar epidermal cysts, most cases develop without a trauma history. Recently, human papillomavirus (HPV) was detected in palmoplantar epidermal cysts in some reports. OBJECTIVE: The purpose of this study was to find out the presence of HPV in palmoplantar epidermal Cysts. METHODS: Seven cases of palmoplantar epidermal cysts were studied using clinical, histopathological, and immunohistochemical examinations. They were also examined by the polymerase chain reaction (PCR) method with general primers and HPV 60 type specific primers. RESULTS: On histological examination, all three characteristic findings, that is, intracytoplasmic eosinophilic bodies in the cyst wall, parakeratosis within the cyst cavity, and the vacuolar structures, were not observed. Immnunohistochemical staining was negative for the papillomavirus common antigen. HPV DNA was not detected in these cases by PCR. CONCLUSION: We could not detect any evidence of HPV infection in our cases of palmoplantar epidermal cysts. It is suggested that either our cases could have developed through a different pathogenesis or our study was done after the disappearance of HPV.

Palmoplantar Epidermal cyst / 대한피부과학회지

BACKGROUND: Although palmoplantar epidermal cysts have long been associated with develop ment following implantation of an epidermal fragment as a result of a penetrating or blunt injury, the pathogenic mechanism is still not fully understood. Since 1987, many cases have been reported in which human papillomavirus(HPV) could be associated with palmoplantar epidermal cysts. OBJECTIVE: In this study, we evaluated the clinicopathological findings of palmoplantar epidermal cysts and investigated them for the presence of HPV in order to examine the role of HPV in the pathogenesis of this disorder in Korea. METHODS: The clinical, histological, immunohistochemical studies were performed on seven cases of plantar cysts, and two cases of palmar cysts. RESULTS: No previous trauma history was seen. Histopathologically, parakeratotic nuclei, or vacuolar strutures within the keratinous mass in the cyst cavity were found. However, we could not find intracytoplasirnic eosinophilic bodies in the wall, the cyst content, or the overlying epidermis. The dyskeratotic keratinocytes were observed in 3 cases. Papillomavirus common antigens were not detected by immunohissochemical staining. CONCLUSIONS: Palmoplantar epidermal cysts in Korea have some different histological features compared to those of HPV 60-associated cases in Japan and we could not detect the immunohistochemical evidence of HPV infection in our cases.