Saturday, December 14, 2013

Vellus Hair Cysts


Abstract: 17 yo boy with scores of papules on abdomen, chest, neck

HPI: 
This 17 yo boy has had 2 - 3 mm papules on chest, abdomen and neck slowly progressive since age 10.  Occasionally the lesions become iflamed.

OE:
Scores of 2 - 3 mm somewhat cystic lesions in above areas.  Some are slightly greyish

Clinical Photo:
 Pathology: (Photomicrographs taken by Dr. Deon Wolpowitz, Department of Dermatopathology, Boston University School of Medicine.
Within the dermis there is a cyst lined by squamous epithelium with a granular layer and containing laminated keratin and numerous vellus hairs.
4x
20x
Diagnosis:  Vellus Hair Cysts

Questions: Has anyone had success treating VHC?  Do they just disappear over time?  Who has seen an adult with with VHC?

Learning Points: (from reference 2)
1. Eruptive vellus hair cysts are a benign, asymptomatic condition, occurring predominantly in children and young adults.
2. Differential diagnoses include milia, comedones, keratosis pilaris, molluscum contagiosum and steatocystoma multiplex.
3.Risk of scarring should always be carefully considered before embarking on surgical or laser treatment.

References:
1.  Vellus Hair Cysts  - eMedicine

2.  Papules on the trunk. Eruptive vellus hair cysts.
Roberts CM, Birnie AJ, Kaye P, Murphy R.
Clin Exp Dermatol. 2010 Apr;3:74-5. doi: 10.1111/j.1365-2230.2009.03494

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