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1.
J Drugs Dermatol ; 20(2): 199-202, 2021 02 01.
Article in English | MEDLINE | ID: mdl-33538555

ABSTRACT

BACKGROUND: Epidermal inclusion cysts (EIC) are one of the most common forms of cysts found on and/or underneath the skin. Inflamed EICs typically show signs and symptoms such as pain and erythema, mimicking cutaneous abscess. However, prior studies have demonstrated at least 20% of lesions are culture negative. OBJECTIVE: To determine the rate of culture positivity in mild inflamed epidermal inclusion cysts, in particular to identify whether empiric antibiotics are warranted. METHODS: In a retrospective chart review 76 cases of inflamed EIC that were mild (lacking systemic symptoms) were analyzed who presented to the department of dermatology at Mount Sinai between 2016–2019. RESULTS: Of cultures taken from inflamed cysts, 47% resulted in no bacterial growth or growth of normal flora, 38.4% resulted in growth of aerobic bacteria with methicillin-resistant Staphylococcus aureus (8%), Staphylococcus lugdunensis (5%), and methicillin-sensitive Staphylococcus aureus (13%) predominating, and 9.3% resulting in growth of anaerobic bacteria with Finegoldia magna, Peptostreptococcus, and Cutibacterium acnes presenting. Review of prescribed treatment regimens often involved antibiotic medication, despite a high prevalence of negative culture. CONCLUSIONS: Almost half of cases of mild inflamed EIC (lacking systemic symptoms) cultured will not grow pathogenic bacteria, therefore incision and drainage with culture and appropriate therapy is a viable therapeutic option in uncomplicated inflamed EIC lesions. In this way, over prescription of antibiotics can be minimized. J Drugs Dermatol. 2021;20(2):199-202. doi:10.36849/JDD.5014.


Subject(s)
Abscess/diagnosis , Anti-Bacterial Agents/therapeutic use , Drainage , Epidermal Cyst/diagnosis , Gram-Positive Bacterial Infections/diagnosis , Abscess/microbiology , Abscess/therapy , Anti-Bacterial Agents/pharmacology , Clinical Decision-Making , Diagnosis, Differential , Drug Resistance, Bacterial , Epidermal Cyst/immunology , Epidermal Cyst/microbiology , Epidermal Cyst/therapy , Epidermis/microbiology , Epidermis/pathology , Epidermis/surgery , Firmicutes/isolation & purification , Gram-Positive Bacterial Infections/immunology , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Bacterial Infections/therapy , Humans , Peptostreptococcus/isolation & purification , Propionibacterium acnes/isolation & purification , Retrospective Studies , Staphylococcus/isolation & purification
3.
J Invest Dermatol ; 137(11): 2417-2426, 2017 11.
Article in English | MEDLINE | ID: mdl-28754339

ABSTRACT

In this study, we observed that mice lacking the IL-1 receptor (IL-1R) (IL1r-/-) or deficient in IL1-ß developed multiple epidermal cysts after chronic UVB exposure. Cysts that developed in IL1r-/- mice were characterized by the presence of the hair follicle marker Sox 9, keratins 10 and 14, and normal melanocyte distribution and retinoid X receptor-α expression. The increased incidence of cysts in IL1r-/- mice was associated with less skin inflammation as characterized by decreased recruitment of macrophages, and their skin also maintained epidermal barrier function compared with wild-type mice. Transcriptional analysis of the skin of IL1r-/- mice after UVB exposure showed decreased gene expression of proinflammatory cytokines such as tumor necrosis factor-α and IL-6. In vitro, primary keratinocytes derived from IL1r-/- mice were more resistant to UVB-triggered cell death compared with wild-type cells, and tumor necrosis factor-α release was completely blocked in the absence of IL-1R. These observations illustrate an unexpected yet prominent phenotype associated with the lack of IL-1R signaling in mice and support further investigation into the role of IL-1 ligands in epidermal repair and innate immune response after damaging UVB exposure.


Subject(s)
Epidermal Cyst/radiotherapy , Gene Expression Regulation , Immunity, Innate/genetics , Keratinocytes/immunology , Keratinocytes/radiation effects , Ultraviolet Rays/adverse effects , Animals , Biopsy, Needle , Blotting, Western , Cells, Cultured , DNA Damage/radiation effects , Disease Models, Animal , Epidermal Cyst/immunology , Epidermal Cyst/pathology , Female , Immunohistochemistry , Keratinocytes/pathology , Mice , Mice, Inbred C57BL , Mice, Knockout , Random Allocation , Real-Time Polymerase Chain Reaction , Receptors, Interleukin/deficiency , Receptors, Interleukin/immunology , Sensitivity and Specificity
4.
Dermatology ; 224(1): 15-9, 2012.
Article in English | MEDLINE | ID: mdl-22456201

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.


Subject(s)
Epidermal Cyst/pathology , Facial Dermatoses/pathology , Hair , Hamartoma/pathology , Neoplasms, Adnexal and Skin Appendage/pathology , Adolescent , Epidermal Cyst/immunology , Facial Dermatoses/immunology , Filaggrin Proteins , Hamartoma/immunology , Humans , Male , Neoplasms, Adnexal and Skin Appendage/immunology
5.
J Cutan Pathol ; 37(2): 282-6, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19602059

ABSTRACT

BACKGROUND: Molluscum contagiosum (MC) causes characteristic cutaneous lesions that occur mainly in children, sexually active adults, and immunocompromised individuals, especially those with human immunodeficiency virus (HIV) infection. Patients infected with HIV, particularly those with advanced disease, have an increased incidence, up to 33.3%, of MC in non-anogenital areas. MC has been rarely found to be associated with epidermoid cysts. CASE REPORT: A 44-year-old male with HIV infection presented with the complaint of a-3-month history of a tender nodule on the left neck. H&E stained sections showed a ruptured cyst, lined with squamous epithelium showing cytopathic changes of MC, and a xanthogranuloma-like inflammatory reaction with characteristic Touton-type giant cells. CONCLUSION: MC infections are common, however MC associated with epidermoid cysts is infrequent. A few cases of MC occurring in epidermoid cysts have previously been reported. We are presenting a case of MC involving an epidermoid cyst in an AIDS patient, with a unique xanthogranuloma-like reaction. Xanthogranulomatous (XG) reactions have been infrequently reported in association with other viral infections, however, poxvirus-associated XG reaction has only been observed in animals. This is the first reported case of MC-associated XG reaction in humans.


Subject(s)
Epidermal Cyst/complications , Granuloma/complications , HIV Infections/complications , Molluscum Contagiosum/complications , Molluscum Contagiosum/immunology , Skin Diseases/complications , Xanthomatosis/complications , Adult , Epidermal Cyst/immunology , Epidermal Cyst/pathology , Granuloma/immunology , Granuloma/pathology , HIV Infections/pathology , Humans , Immunocompromised Host , Male , Molluscum Contagiosum/pathology , Skin Diseases/immunology , Skin Diseases/pathology , Xanthomatosis/immunology , Xanthomatosis/pathology
6.
BMJ Case Rep ; 20102010 Aug 26.
Article in English | MEDLINE | ID: mdl-22767471

ABSTRACT

Epithelial splenic cysts are rare entities that surgeons might not have previously encountered and their management is based on historical studies. A 21-year-old female presented with a cyst of the spleen that produced a high serum concentration of carbohydrate antigen CA 19-9. A partial splenectomy with the removal of the entire cyst and preservation of splenic parenchyma by laparotomy was performed and the patient made an uneventful recovery. A microscopic rupture of the wall of the cyst and degradation of blood in the fluid of the cyst were confirmed. Eighteen months following surgery a functional splenic parenchyma was documented. There was no episode of infection during this follow-up time. Partial surgical splenectomy with resection of the entire cyst prevents recurrence and preserves splenic function.


Subject(s)
CA-19-9 Antigen/immunology , Epidermal Cyst/pathology , Splenectomy/methods , Splenic Diseases/pathology , Biopsy, Needle , Epidermal Cyst/immunology , Epidermal Cyst/surgery , Female , Follow-Up Studies , Humans , Immunohistochemistry , Laparotomy/methods , Risk Assessment , Rupture, Spontaneous/diagnosis , Rupture, Spontaneous/surgery , Splenic Diseases/immunology , Splenic Diseases/surgery , Treatment Outcome , Young Adult
7.
Ann Ital Chir ; 77(5): 443-6, 2006.
Article in English | MEDLINE | ID: mdl-17345995

ABSTRACT

True cysts of the spleen are rare; in a few cases, high serum levels of carbohydrate and cancer antigen have been reported. In such instances, cyst resection or splenectomy is indicated to rule out malignant lesions and to remove the cancer antigen producing epithelium. We report the case of a young woman with a symptomatic giant epidermoid cyst of the spleen. Due to the secreting epithelium lining the cyst, serum levels of CA 19-9 and CA 125 were elevated. Laparoscopic splenectomy achieved symptoms relief and and long-term normalization of serum tumor markers.


Subject(s)
Antigens, Tumor-Associated, Carbohydrate/immunology , Epidermal Cyst , Laparoscopy/methods , Splenic Diseases , Adult , Epidermal Cyst/immunology , Epidermal Cyst/pathology , Epidermal Cyst/surgery , Female , Humans , Splenic Diseases/immunology , Splenic Diseases/pathology , Splenic Diseases/surgery
8.
Int J Urol ; 11(12): 1150-2, 2004 Dec.
Article in English | MEDLINE | ID: mdl-15663695

ABSTRACT

Median raphe cyst (MRC) is a benign lesion occurring predominantly in the ventral surface of the penises of young men and is an embryological developmental anomaly of the male genitalia. Serous borderline tumors (SBT) are found most frequently in the female ovary and only several cases with SBT of the male genitalia have been reported. We describe a case of MRC with features of SBT, which appeared in the scrotum of a 9-year-old boy after orchiopexy and was associated with surgery for cryptorchidism. The cyst arose on the right testicular tunica and consisted of cystic components with intracystic papillae lined by stratified epithelial cells, some of which showed mild cytological atypia and sporadic mitosis. These epithelial cells expressed CA 125, CA 19-9, carcinoembryonic antigen, estrogen receptor and progesterone receptor. Although no cases of MRC with characteristics of SBT in association with the rete testis has been described, the current report gives additional information for follow-up of cryptorchidism.


Subject(s)
Cryptorchidism/complications , Cystadenoma, Serous/pathology , Epidermal Cyst/pathology , Orchiectomy , Scrotum/pathology , Child , Cryptorchidism/immunology , Cryptorchidism/surgery , Diagnosis, Differential , Epidermal Cyst/etiology , Epidermal Cyst/immunology , Humans , Male , Scrotum/immunology
10.
Histopathology ; 26(5): 467-9, 1995 May.
Article in English | MEDLINE | ID: mdl-7544765

ABSTRACT

Cutaneous ciliated cysts of the lower limb are rare. Almost exclusively occurring in women they have been widely regarded as Müllerian heterotopias. A second case in a man is reported, the literature reviewed and the origin of this lesion briefly discussed.


Subject(s)
Epidermal Cyst/pathology , Foot , Actins/analysis , Adult , Carcinoembryonic Antigen/analysis , Epidermal Cyst/immunology , Humans , Keratins/analysis , Male , Membrane Glycoproteins/analysis , Mucin-1 , Mucins/analysis , S100 Proteins/analysis
14.
Nihon Hifuka Gakkai Zasshi ; 100(2): 199-203, 1990 Feb.
Article in Japanese | MEDLINE | ID: mdl-2165193

ABSTRACT

A total of 23 cases of human papillomavirus-associated epidermoid cysts, including one presented here, have been reported in Japan. A review of the literature revealed that the appearance of eosinophilic intracellular substances and that of vacuolar substances in the horny layer of cysts characterize these cases. High detection of human papillomavirus, the pathological features in these cases, and the observation of our case from the onset in which verrucous lesions had preceded a cyst may favor the possibility that HPV would directly produce cysts in these cases.


Subject(s)
Antigens, Viral/analysis , Epidermal Cyst/immunology , Foot Dermatoses/immunology , Papillomaviridae/immunology , Adolescent , Cryosurgery , Epidermal Cyst/etiology , Foot Dermatoses/etiology , Humans , Male , Tumor Virus Infections , Warts/etiology , Warts/surgery
15.
J Cancer Res Clin Oncol ; 116(5): 525-7, 1990.
Article in English | MEDLINE | ID: mdl-2229145

ABSTRACT

HLA-A and B antigens were determined in a study of 162 patients (93 epidermoid type, 20 adenocarcinoma, 26 small-cell carcinoma and 23 undifferentiated types) with lung cancer. Differences between antigen frequencies in cancer and control populations were studied by chi 2Y analysis or Fisher's exact test. Survival data were analyzed using Cox's model for censored data. Cancer patients had a decreased frequency of the antigen HLA-B40 (chi 2Y = 14.15, P = 0.00018, Pc = 0.003, relative risk = 0.21). Patients with HLA-A10, A 11 and B27 had a shortened mean survival time. Patients with HLA-B12 had a prolonged survival time.


Subject(s)
HLA-A Antigens/analysis , HLA-B Antigens/analysis , Lung Neoplasms/immunology , Adenocarcinoma/immunology , Epidermal Cyst/immunology , Humans , Survival Analysis
16.
J Cutan Pathol ; 16(6): 375-81, 1989 Dec.
Article in English | MEDLINE | ID: mdl-2559111

ABSTRACT

An epidermoid cyst of the sole was studied immunohistochemically and ultrastructurally. Papillomavirus particles were present in the horny layer and in the upper layers of the epidermis of the cyst and within the acrosyringeal epithelium overlying the cyst. Thickened basal lamina-like structures similar to those found in the eccrine sweat duct tumors such as in cylindroma and eccrine spiroadenoma existed at the epidermal-dermal junction of the cyst wall. Carcinoembryonic antigen was immunohistochemically demonstrated in the center of the epidermoid cyst and the DAB reaction products took the shape of a circle resembling that of the sweat ducts in the horny layer.


Subject(s)
Antigens, Viral/analysis , Epidermal Cyst/immunology , Foot , Papillomaviridae/immunology , Skin Diseases/immunology , Adult , Epidermal Cyst/pathology , Humans , Immunohistochemistry , Male , Microscopy, Electron , Skin Diseases/pathology
17.
Arch Dermatol Res ; 281(1): 31-4, 1989.
Article in English | MEDLINE | ID: mdl-2786384

ABSTRACT

We investigated in vitro the contents of epidermal cysts for complement activation and found that they activated complement mainly through the alternative pathway. Chemotactic C5a anaphylatoxin produced by the cyst contents after contact with serum most likely plays a significant role in the initiation and aggravation of inflammation in ruptured epidermal cysts. Our additional study disclosed that components of three representative follicular resident microorganisms (Pityrosporum ovale, Propionibacterium acnes, and Staphylococcus epidermidis) also produced C5a anaphylatoxin mainly through the alternative pathway; the C5a production was more vigorous than that by a virulent pathogen, Staphylococcus aureus. These results suggest that accidental colonization of the cyst contents by these follicular microbial flora further augments the inflammatory changes in ruptured epidermal cysts.


Subject(s)
Anaphylatoxins/biosynthesis , Chemotaxis, Leukocyte , Complement C5/immunology , Epidermal Cyst/immunology , Peptide Biosynthesis , Adult , Complement Activation , Complement C4/immunology , Complement C4a , Complement C5a , Epidermal Cyst/microbiology , Foot Dermatoses/immunology , Foot Dermatoses/microbiology , Humans , Malassezia/immunology , Neutrophils/metabolism , Propionibacterium/immunology , Staphylococcus/immunology
18.
Arch Dermatol Res ; 279(7): 449-53, 1987.
Article in English | MEDLINE | ID: mdl-3435173

ABSTRACT

Epidermal cysts are one of the most common tumors of the skin. Although asymptomatic ordinarily, they may sometimes become severely inflamed with massive invasion of polymorphonuclear leukocytes (PMN). We studied in vitro PMN chemotactic properties of the aqueous extract prepared from the horny material of epidermal cysts obtained from three patients. A crude aqueous extract of the horny content of the cysts showed PMN chemotactic activity, which, however, was less than that of a horny layer extract prepared from normal skin. Characterization of PMN chemotactic activity using a Sephadex G-75 column showed a peak in the low molecular weight fractions eluting between the vitamin B12 and phenol red markers, which corresponds with the peak of absorbance at 280 nm. The chemotactic substances withstood boiling and trypsin or protease digestion. Although the chemotactic activity was partially ether-extractable, the presence of leukotriene B4 was not demonstrated by radioimmunoassay. In addition to their own chemotactic activity, the horny extracts of epidermal cysts showed cytotaxigenic properties in the presence of fresh serum.


Subject(s)
Chemotactic Factors/biosynthesis , Chemotaxis, Leukocyte , Epidermal Cyst/metabolism , Adult , Chromatography, Gel , Epidermal Cyst/immunology , Humans
20.
J Am Acad Dermatol ; 9(6): 867-71, 1983 Dec.
Article in English | MEDLINE | ID: mdl-6196384

ABSTRACT

Four highly sensitive monoclonal antibodies were assessed for their use in an immunoperoxidase technic on cutaneous sections. Three, B2, C23, and 2A1, were found to discriminate basal cell carcinomas (BCCs) from benign proliferative disorders of skin, and 2A1, a monoclonal antibody against the heavy chain component of class 1 human leukocyte antigens (HLA) for the first time directly demonstrated the absence of this structure from the malignant cell membrane. However, the deeper portions of hair follicles were also found to be unlabeled, and further study of benign follicular tumors which may histologically mimic basal cell carcinomas is suggested.


Subject(s)
Antibodies, Monoclonal , Carcinoma, Basal Cell/immunology , HLA Antigens/analysis , Skin Neoplasms/immunology , Biopsy , Epidermal Cyst/immunology , Epitopes , Hair/immunology , Humans , Keratoacanthoma/immunology , Skin Diseases/immunology , Warts/immunology , beta 2-Microglobulin/analysis
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