Skin cysts
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Author:
Mikael Häggström [note 1]
Contents
Microscopic evaluation
Major initial clues are:
- Whether the lining of the cyst is stratified squamous epithelium, non-stratified squamous epithelium, or absence of epithelium (pseudocysts):[1]
- Location of the cyst.[1]
Stratified squamous epithelium
Location | Main diagnoses[1] |
---|---|
Face |
|
Scalp |
|
Trunk |
|
Pelvic, anogenital |
|
Axilla and groin |
|
Preauricular |
|
Upper gluteal cleft and sacrococcygeal area |
|
Non-stratified squamous epithelium
Location | Main diagnoses[1] |
---|---|
Face |
|
Suprasternal notch |
|
Midline anterior neck |
|
Lateral neck, preauricular, mandibular |
|
Lower extremities |
|
Labia majora |
|
Ventral glans and penile shaft |
|
Umbilical or periumbilical |
|
Absence of epithelium (pseudocyst)
Location | Main diagnoses[1] | Histology | Image |
---|---|---|---|
Oral mucosa | Mucocele (lower labial) | ||
Dorsal aspect of distal phalanx of finger or toe |
|
||
Wrist (and generally other locations close to joints or tendon sheaths) | Walls composed of bland fibrous tissue. | ||
Scaphoid fossa of the ear |
|
||
Sites of surgical trauma |
|
Diagnoses
Epidermoid cyst
- Main article: Epidermoid cyst
Also known as epidermal inclusion cyst (EIC) and sebaceous cyst. Typical findings:[3]
- Stratified squamous epithelium with a granular layer
- Cyst wall does not contain eccrine glands, sebaceous glands or hair follicles
- Abundant keratin flakes in cyst lumen
- Often giant cell granuloma in ruptured cysts, similar to foreign body granuloma
Trichilemmal cyst
The constitution of a trichilemmal cyst (also called pilar cyst), from external (top) to internal (bottom):[4]
- Fibrous capsule
- Small, cuboidal, dark-staining basal epithelial cells in a palisade arrangement, with no distinct intercellular bridging
- Swollen pale keratinocytes, which increase in height closer to the interior
- Solid eosinophilic-staining keratin
There is no granular cell layer (in contrast to an epidermoid cyst).
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ 1.0 1.1 1.2 1.3 1.4 page 1917 in: Bolognia, Jean (2018) (in de). Dermatology . Philadelphia, Pa: Elsevier. ISBN 978-0-7020-6342-8. OCLC 1011508489.
- ↑ Pakistan: Kamyab, Kambiz; Kianfar, Nika; Dasdar, Shayan; Salehpour, Zahra; Nasimi, Maryam (2020). "Cutaneous cysts: a clinicopathologic analysis of 2,438 cases ". International Journal of Dermatology. doi: . ISSN 0011-9059.
- ↑ V. Claire Vaughan, M.D., Joshua Wisell, M.D.. Skin nonmelanocytic tumor - Cysts - Epidermal (epidermoid) type. pathology Outlines. Topic Completed: 9 May 2019. Revised: 13 December 2019
- ↑ Anne Elizabeth Laumann. Which histologic findings are characteristic of trichilemmal cyst (pilar cyst)?. Medscape. Updated: Jun 11, 2020,
Image sources