Derm Dx: A rare neoplasm on the nose - Clinical Advisor

Derm Dx: A rare neoplasm on the nose

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An 87-year-old man presents with a lesion that has been present on his nose for several months. The growth is asymptomatic and has never bled. He denies prior history of skin cancer or occurrence of lesions with similar appearance. Examination reveals a 3-mm flesh-colored papule of his left nares.

Results of clinical examination favored a diagnosis of fibrous papule or basal cell carcinoma; however, biopsy revealed steatocystoma. Most steatocystoma occur as part of a complex characterized by the occurrence of smooth flesh- to sallow-colored cysts. These cysts occur predominately...

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Results of clinical examination favored a diagnosis of fibrous papule or basal cell carcinoma; however, biopsy revealed steatocystoma.

Most steatocystoma occur as part of a complex characterized by the occurrence of smooth flesh- to sallow-colored cysts. These cysts occur predominately on the trunk and upper arms and first appear in adolescence or early adulthood.1 The condition is termed steatocystoma multiplex, and it may arise either sporadically or as an autosomal-dominant disorder linked to an abnormality in gene coding for keratin.2 Cysts are believed to arise from a malformation at the pilosebaceous duct junction.

 

Steatocystoma simplex is a rare neoplasm with histopathology that is identical to that of steatocystoma multiplex, but steatocystoma simplex occurs on facial sites, including the ear and nose.3-5 Most reported cases occur in middle-aged or elderly patients6; however, recently steatocystoma simplex was documented in a 4-year-old child.7 Simple excision of the cyst is curative.

Stephen Schleicher, MD, is an associate professor of medicine at the Commonwealth Medical College in Scranton, Pennsylvania, and an adjunct assistant professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. He practices dermatology in Hazleton, Pennsylvania.

References

  1. Cho S, Chang SE, Choi JH, Sung KJ, Moon KC, Koh JK. Clinical and histologic features of 64 cases of steatocystoma multiplex. J Dermatol. 2002;29:152-156.
  2. Oh SW, Kim MY, Lee JS, Kim SC. Keratin 17 mutation in pachyonychia congenita type 2 patient with early onset steatocystoma multiplex and Hutchinson-like tooth deformity. J Dermatol. 2006;33:161-164.
  3. Bowyer J, Sullivan T, Whitehead K. Steatocystoma simplex of the caruncle. Br J Ophthalmol. 2003;87:240-241.
  4. Tirakunwichcha S, Vaivanijkul J. Steatocystoma simplex of the eyelid. Ophthal Plast Reconstr Surg. 2009;25:49-50.
  5. Ishida Y, Takahashi Y, Takahashi E, Kitaguchi Y, Kakizaki H. Steatocystoma simplex of the lacrimal caruncle: a case report. BMC Ophthalmol. 2016;16:183.
  6. Brownstein MH. Steatocystoma simplex. A solitary steatocystoma. Arch Dermatol. 1982;118:409-411.
  7. Araujo KM, Denadai R. Clinical misdiagnosis of steatocystoma simplex of eyebrow in a pediatric patient. Chin Med J (Engl). 2016;129:377-378.
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