"Extraction Dermoscopy": Expanding the Utility of Epiluminescence Microscopy.

INTRODUCTION: Many dermatological conditions require extraction of material from the lesion followed by visualization under a microscope. However, visualization of the extracted material can be done using a dermoscope instead. We propose "extraction dermoscopy" as an addition to the already existing treasury that dermoscopy holds. METHODS: After approval from the institutional ethics committee, a cross-sectional study was carried out in a tertiary care hospital. Polarized and non-polarized versions of in vivo dermoscopy, as well as extraction dermoscopy, were performed on a total of 77 lesions, including 5 eruptive vellus hair cysts, 2 cilia incarnata externum, 10 trichostasis spinulosa, 20 keratosis pilaris, 20 molluscum contagiosum, and 20 lesions of milia. Heine Delta 20T and Dino-Lite Premier AM4113T were employed for dermoscopic examination. RESULTS: A total of 77 lesions were selected, including 5 eruptive vellus hair cysts, 2 cilia incarnata externum, 10 trichostasis spinulosa, 20 keratosis pilaris, 20 molluscum contagiosum, and 20 lesions of milia. Extraction dermoscopy of the eruptive vellus cysts revealed skin color to brownish colored cysts with a bunch of pigmented hair. Similarly, findings of all other lesions were described and recorded post-extraction. CONCLUSION: Extraction dermoscopy helps confirm the diagnosis without visualization under a microscope. Its application in recent times makes the explanation of the nature of many disorders to patients easier, and demonstration of extracted lesions may further improve doctor-patient communication.

Stüve-Wiedemann syndrome with multiple eruptive vellus hair cysts and clefted tongue.

Stüve-Wiedemann syndrome is a rare autosomal recessive congenital primary skeletal dysplasia, characterized by small stature, bowed long bones, joint restrictions, hyperthermic episodes, dysautonomia, and respiratory and feeding difficulties, that usually leads to early mortality. Cutaneous manifestations have rarely been reported. We report the case of a girl with Stüve-Wiedemann syndrome presenting with progressive development of multiple eruptive vellus hair cysts.

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.

Eruptive Vellus Hair Cyst: An Uncommon and Underdiagnosed Entity.

Eruptive vellus hair cyst (EVHC) is a rare follicular developmental abnormality of the vellus hair follicles. They are usually seen in children, adolescents, or young adults and manifest as reddish-brown smooth papules most commonly involving the chest, limbs, and abdomen. An 18-year-old male presented with asymptomatic papules on the trunk and flexor aspect of both forearms for the past 2 years. There was no family history of similar lesions. His medical history was also not contributory. A clinical diagnosis of steatocystoma multiplex and chronic folliculitis was given, and a punch biopsy from the papule was performed and sent for histopathological examination. On microscopic examination, a final diagnosis of EVHC was rendered. The patient was advised topical treatment of retinoic acid cream (0.05%) for 6 months, and he is currently under follow-up period. Due to its rarity and resemblance to many similar entities, histopathological examination plays a major role in establishing a definite diagnosis and further proper management of the patient. We report this unusual case to generate awareness about this rarely diagnosed condition.

Quistes vellosos eruptivos con compromiso facial: presentación de un caso / Eruptive vellus hair cyst with facial involvement: case report

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.

Eruptive vellus hair cyst presenting as asymptomatic follicular papules on extremities.

Eruptive vellus hair cysts were first described in 1977. They usually appear as yellow to reddish-brown papules on the chest. Usual onset is between ages 17 and 24 years, but they may be congenital. Some believe that they may be inherited as an autosomal dominant disorder. Histologically the cyst has a stratified squamous epithelium and it contains laminated keratin and vellus hairs. They are felt to be caused by an abnormality at the infundibular level of the vellus hair. We present this because of this patient's unusual distribution of eruptive vellus hair cysts.

A case of eruptive vellus hair cysts that developed on the labium major.

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.

A Case of Eruptive Vellus Hair Cyst Involving the Face, Trunk, and Extremities / 대한피부과학회지

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.

A Case of Eruptive Vellus Hair Cysts That Developed on the Labium Major

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.

Two Pilosebaceous Cysts with Apocrine Hidrocystoma in One Biopsy Site: A Spectrum of the Same Disease Process?

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.

Two Pilosebaceous Cysts with Apocrine Hidrocystoma in One Biopsy Site: A Spectrum of the Same Disease Process?

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.

A Case of Eruptive Vellus Hair Cyst Treated by Mini-incision / 대한피부과학회지

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.

A Case of Congenital Eruptive Vellus Hair Cyst / 대한피부과학회지

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.

A Case of Eruptive Vellus Hair Cysts Associated with Milia on the Face / 대한피부과학회지

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.

A Case of Eruptive Vellus Hair Cyst Combined With Steatocystoma Multiplex / 대한피부과학회지

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.

A Case of Hybrid Cyst showing Composite Features of an Eruptive Vellus Hair Cyst and Steatocystoma Multiplex / 대한피부과학회지

Both eruptive vellus hair cyst and steatocystoma multiplex are uncommon conditions. There are clinical similarities between these two entities, but histological features are distinctive. We describe a patient with multiple subcutaneous nodules on the chest and both axilla, showing combined histological features of both an eruptive vellus hair cyst and steatocystoma multiplex. This case suggests that eruptive vellus hair cyst and steatocystoma multiplex are variants of one disorder which originate in the pilosebaceous duct.

A Case of Eruptive Vellus Hair Cyst Associated with Steatocystoma multiplex / 대한피부과학회지

Eruptive vellus hair cysts and steatocystoma multiplex have clinical similarities in terms of age of onset, location and appeararice of the lesions, but histopathologic feitures are distinctively differen-tiated. We present herein a 37-year-old woman with eruptive vellus hair cyst and steatocystoma multiplex as well. The histopathologic sections from 2 different lesions showed features of both eruptive vellus hair cyst with sebaceous gland in and near the cyst wall, and steatocy toma multiplex with rudimentary hair follicle near the cyst wall. This case may support the premie that eruptive vellus hair cyst and steatocystoma multiplex have a common developmental origin.