Derm Dx: Cysts on the Trunk and Buttocks - Clinical Advisor

Derm Dx: Cysts on the Trunk and Buttocks

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A 24-year-old man is referred for evaluation of numerous white cysts on his trunk and buttocks. The patient began developing the lesions during adolescence. They are asymptomatic, but he finds them unsightly. He states that his father also had similar cysts, but far fewer in number. Examination reveals >50 firm nodules that vary in size from 0.5 to 2.0 cm.

Steatocystoma multiplex is a keratinization disorder that produces multiple asymptomatic papules and nodules called steatocystomas, which are found where pilosebaceous units (sebaceous glands and hair follicles) are well-developed.1 Common sites of involvement are the extremities, neck, and trunk.2 Steatocystoma multiplex...

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Steatocystoma multiplex is a keratinization disorder that produces multiple asymptomatic papules and nodules called steatocystomas, which are found where pilosebaceous units (sebaceous glands and hair follicles) are well-developed.1 Common sites of involvement are the extremities, neck, and trunk.2 Steatocystoma multiplex is an inherited autosomal dominant condition, although cases may be sporadic in nature. Onset typically occurs in childhood to young adulthood.3 Steatocystoma multiplex is related to eruptive vellus hair cysts, as both conditions originate in the pilosebaceous duct.4

Treatment options for steatocystoma multiplex include surgical excision, destructive laser therapy, simple drainage with or without ablation of the cyst wall, and the prescription of oral isotretinoin.5 The latter has shown variable results, and antibiotics are ineffectual. No consensus exists regarding the best treatment option; an individualized approach is recommended.2,5

Nelson Maniscalco, DPM, is a joint podiatry/dermatology fellow under the aegis of St Lukes Medical Center in Allentown, Pennsylvania, and the DermDox Center for Dermatology. Stephen Schleicher, MD, is director of the DermDox Center for Dermatology, associate professor of medicine at Commonwealth Medical College, and clinical instructor of dermatology at Arcadia University and Kings College.

References

1. Vivas A, Keri J, Steatocystoma multiplex. In: Acneiform Eruptions in Dermatology. New York, NY: Springer; 2014;343-348.

2. Amin M, Hashim P. Steatocystoma multiplex: case report and review of treatment. Skin J Cutan Med. 2018;2(1):75-79.

3. Yamada A, Saga K, Jimbow K. Acquired multiple pilosebaceous cysts on the face having the histopathological features of steatocystoma multiplex and eruptive vellus hair cysts. Int J Dermatol. 2005;44(10):861-863.

4. 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(3):152-156.

5. Kamra HT, Gadgil PA, Ovhal AG, Narkhede RR. Steatocystoma multiplex- a rare genetic disorder: a case report and review of literature.J Clin Diagn Res. 2013;7(1):166-168.

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