I wouldnt dare tell you i had cure, but i think i can be helpful. Dermatopathology reference describes eruptive vellus hair cyst histopathology including histologic features and provides links to additional medical references. Multiple subcutaneous cysts ranging in diameter from 5 mm to 10 mm occurred on the axillary fossa. Therefore, we performed morphometric measurements on histological sections of human terminal thf and vellus hair follicles vhf from the scalp and the retroauricular region. Eruptive vellus hair cyst haritha k, parthasaradhi a, jalu j. The eruptive vellus hair cyst is an uncommon, yet distinct, clinical and pathological entity that may be acquired in a sporadic or hereditary form. An association between steatocystoma multiplex scm and eruptive vellus hair cysts evhcs has been recognized. With eb, milia were seen in connection with eccrine ducts. Vellus hair definition of vellus hair by medical dictionary.
It contains laminated keratinous material and varying numbers of transversely and obliquely cut vellus hairs. Evhc may be present at birth and may appear at any age, although they show a clear trend towards occurring during the first 3 decades of life. The cyst wall contains a dense lymphoid tissue, usually with germinal centers fig. This is, to our knowledge, the second report of eruptive vellus hair cysts. Microscopically, it is usually seen in the middermis lined by squamous epithelium. Mechanical dermabrasion, retinoids, needle evacuation, simple excision, or laser therapy microscopic dermal cyst lined by bland stratified squamous epithelium with granular layer intraluminal laminated keratin debris and numerous vellus hair shafts small hair folliclespilosebaceous units may be seen attached to cyst wall top differential diagnoses epidermoid epidermal. Histological elucidation is characteristic and diverse. Evhc is a benign disease, and its exact cause is unknown. They may be connected to a vellus hair follicle or eccrine sweat duct3.
Multiple eruptive vellus hair cysts treated with carbon dioxide laser vaporization. Eruptive vellus hair cyst with hair bulbs, middermal location and thick, stratified squamous epithelial layer 14. They are related conditions representing nevoid malformations of the pilosebaceous junctions 110 that have similar clinical features but distinctive histologic features. What is vellus hair vellus hairs are fine, blond hairs normally growing on the face, trunk and limbs in contrast to terminal hairs, which are longer, pigmented, and mainly arising on the scalp, beard, underarms and pubic area what are eruptive vellus hair cysts eruptive vellus hair cysts are small papules containing vellus hairs. Treatment of multiple eruptive vellus hair cysts with carbon dioxide laser vaporization and manual lateral pressure. Eruptive vellus hair cysts are thought to be the result of occlusion blockage at the level of the infundibulum the part of the hair follicle just below the epidermis, subsequent cystic dilatation enlargement of the hair follicle and secondary atrophy withering of the hair bulb. Histology shows normal number of follicles, increased vellus and telogen hairs, no significant inflammation. Velus hair cyst, he 60x 14347 velus hair cyst, he 60x 14345 velus hair cyst, he 60x 14346 hybrid vellus hair cyst and steatocyst. Biopsies demonstrated multiple middermal cysts containing vellus hair shafts. Pathogenesis eruptive vellus hair cysts, first introduced by esterly et al 1 in 1977, are uncommon benign lesions presumed to be caused by an abnormal development of the infundibular portion of the hair follicle. Eruptive vellus hair cyst belongs to a spectrum of pilosebaceous cysts engendered from the.
Eruptive vellus hair cyst evhc is a term proposed and published for the first time by esterly et al. Recently minimally painful or painless, nonscarring techniques have been described. Eruptive vellus hair cysts are a type of cutaneous cyst of skin appendages which is usually seen in children and teenager. Jan 01, 2000 we describe a combined cutaneous hamartoma in a 57. The cysts contain multiple crosssections of vellus hairs and layered laminated keratinous material. Scanning power view of trichilemmal cyst shows a epithelial lined cyst filled with brightly eosinophilic keratinaceous debris figure 1. Histologically, the lesions consisted of small cysts. Dermoscopy distinction of eruptive vellus hair cysts with. Histopathology of eruptive vellus hair cysts evhcs shows a cystic structure in the mid dermis arising from the infundibulum of a hair follicle. Both conditions most commonly involve the anterior aspect of the chest. Nevertheless, there are few studies on the origin of milia. They are lined by squamous epithelium 2 to 5cells thick.
Intradermal eruptive vellus hair cyst with vellus hair fragments and attenuated squamous epithelium. Monomorphic or multivariate eruptive vellus hair cyst juniper. Eruptive vellus hair cyst stratified squamous epithelium with granular layer multiple vellus hair shafts inside pilomatricoma rarely on scrotal skin firm nodules, mostly single tumours islands of epithelial cells composed of ghost cells in the centre surrounded by basaloid cells idiopathic scrotal calcinosis no. Cases have been published with the cysts showing the features of both steatocystoma multiplex and eruptive vellus hair cysts, which are caused by a cystic change in the same pilosebaceous duct. Facial variant of eruptive vellus hair cyst bhushan p, singh a ijdvl. The histopathology of the eruptive vellus hair cysts evhcs shows dermal cysts. Eruptive vellus hair cysts eruptive vellus hair cysts burns, d. Histopathological findings demonstrated a cystic structure lined by squamous epithelium in the lower dermis. Diagnosis is generally made by clinical presentation and confirmed with punch biopsy and histological examination. Eruptive vellus hair cyst presenting as asymptomatic. The cysts appear similar clinically to steatocystoma.
An aalternative diagnosing methodlternative diagnosing method sir, eruptive vellus hair cysts evhc are unusual developmental abnormality of vellus hair follicles. So, these small cysts contain coiled up vellus hair, which is that fine downy hair that you see in newborns or on the cheeks and temples of adult faces. Morphometry of human terminal and vellus hair follicles. The gradual disruption at the infundibular level would result in occlusion and subsequent retention of hairs, cystic dilatation of the proximal follicle, and finally, atrophy of the hair bulb. We report a case of a male child who presented with asymptomatic papules on the chest. In eruptive vellus hair cysts, asymptomatic follicular papules 12 mm in diameter occur most commonly on the chest. In tandon study, these findings were in 100%, 96%, 59%, 19%, 30% and 70% respectively. Vellus hair cyst is an uncommon developmental abnormality of the vellus follicle histologically defined as a stratified squamous epitheliallined cyst containing one or more vellus hairs. They are felt to be caused by an abnormality at the infundibular level of the vellus hair. First of all, most of the articles written on them, and i mean articles in medical journals, fall bel. In our study, decrease or lack of terminal hair was seen in 93. Herein, we report three patients with a heretofore described clinicopathologic condition consisting of multiple contiguous cysts of the ear helices showing solar elastosis and multiple. The lesions, which occurred in an 18yearold woman, consisted of 35 to 40 brownishblack, 1 to 4mm papules on the. High power view of eruptive vellus cyst histopathology.
The characteristic histology is that of a middermal cyst containing. A case of eruptive vellus hair cysts that developed on the. Dermatology short, fine, usually nonpigmented which covers much of the body. Dermnet nz does not provide an online consultation service. It is likely that evhc are less rare than it may appear from the scarcity of related publications in the literature. Eruptive vellus hair cysts or evhc are small lesions that occur most often in the chest wall, abdomen and extremities, often with a crusted surface 680 evhc may occur randomly, or it can be inherited as an autosomal dominant trait. Type ii 5alpha reductase enzyme activity and dht levels are increased in aga. Cuboidal or columnar epithelium occurs in some cysts. Cyst wall is constituted of sebaceous lobules or mature sebaceous glands in steatocystoma multiplex and vellus hair follicles in eruptive vellus hair cyst. Jul 29, 2019 eruptive vellus hair cysts evhcs are thought to arise as a developmental abnormality of vellus hair follicles. They described two children who developed asymptomatic papular eruptions over the chest and mentioned two other cases, also children, who presented after submission of the original manu script. A case report of eruptive vellus hair cyst is reported herein in which the epithelial lining differentiated toward the sebaceous duct.
There is no racial predilection and both sexes are affected. The lesions,whichoccurred inan 18yearold woman, consisted of 35 to 40 brownishblack,1to4mm papuleson theanterior aspect of the chest. While numerous cases of epidermoid cyst have been reported in association with an intradermal melanocytic naevus. Eruptive vellus hair cysts were first described in 1977. Histologically, the lesions consisted of small cysts in the middle dermis that. Jan 23, 2016 now, lets talk about these eruptive villus hair cysts evhcs. View image a closeup view of the contents of an eruptive vellus hair cyst showing crosssections of vellus hairs and laminated keratinous material. Usual onset is between ages 17 and 24 years, but they may be congenital. Retinoic acid in the treatment of eruptive vellus hair cysts. Steatocystoma multiplex sm and eruptive vellus hair cysts evhc are uncommon benign tumors of the pilosebaceous unit. Unilateral eruptive vellus hair cysts occurring on the face.
Some have suggested that eruptive vellus hair cysts and sm exist on a disease spectrum because of their similar clinical presentation. Histologically, the lesions consisted of small cysts in the middle dermis that contained laminated andamorphous keratinous material vellus hairs. Pdf a case of eruptive vellus hair cysts that developed on the. Multiple follicular cysts, infundibular type with vellus. Most cases of sm and evhc are sporadic, although less common autosomal dominant inherited forms have been. Vellus hairs and laminated keratinous materials were. Eruptive vellus hair cysts in identical triplets with. Surgical treatment approach in a patient with eruptive vellus hair cyst.
If you have any concerns with your skin or its treatment, see a dermatologist for advice. Are there treatments for removing vellus hair cysts. Treat with minoxidil, finasteride, dutasteride, or hair transplantation. Bilateral vulvar eruptive vellus hair cysts sciencedirect. Eruptive vellus hair cysts request pdf researchgate. A predisposition exists for follicular occlusion at the level of the infundibulum, which results in cystic dilatation of the proximal hair follicle and secondary atrophy of the hair bulb. Eruptive vellus hair cysts probably develop due to occlusion of the infundibulum of vellus hairs with resultant cystic dilatation and retention of. Withprimarymilia, they observed strandlike connections from milial cysts to the external root sheath of vellus hair follicles, near where the sebaceous ducts attach. We report a case of 7yearold girl presented with 2 years history of. The lesions, which occurred in an 18yearold woman, consisted of 35 to 40 brownishblack, 1 to 4mm papules on the anterior aspect of the chest. Eruptive vellus hair cyst haritha k, parthasaradhi a, jalu j indian j.
Commonly affected sites are chest and extremities where they appear as reddishbrown papules. Monomorphic or multivariate eruptive vellus hair cyst. Eruptivevellushaircyst clinicalandhistologicfindings sungnacklee,md,joonggiekim,md thisis,toour knowledge,thesecond report of eruptivevellus hair cysts. Treat with minoxidil, finasteride, dutasteride, or hair. Vellus hair cyst is an uncommon developmental abnormality of the vellus follicle histologically defined as a stratified squamous epithelial. The density of hair the number of hair follicles per area of skin varies from person to person. Both sm and evhc are characterized by smooth, asymptomatic papules or nodules, most commonly presenting on the chest, limbs, and abdomen. Histopathology of an eruptive vellus hair cyst showing a middermal cyst with squamous epithelium. Histologically the cyst has a stratified squamous epithelium and it contains laminated keratin and vellus hairs. Vellus hair is short, thin, slightcolored, and barely noticeable hair that develops on most of a persons body during childhood.
Histologically, these papules had the unique characteristic of dermal cysts containing small vellus. Simple approach to histological diagnosis of common skin. Cooccurrence of steatocystoma multiplex, eruptive vellus. Eruptive vellus hair cysts are benign lesions that can be difficult to distinguish from other skin conditions, including molluscum contagiosum and acne vulgaris. The hair shaft is quite narrow, sometimes more than the root sheath itself. We emphasize differing dermoscopy features to help distinguish eruptive vellus hair cysts from molluscum contagiosum or acne. Eruptive vellus hair cysts evhcs were first described by esterly, fretzin, and pinkus in 1977. Steatocystoma multiplex sm and eruptive vellus hair cysts evhc are. Some consider it to be a hamartomatous differentiation toward vellus hair follicles while others believe it is a rare developmental abnormality of vellus hair follicles. It is seen on the scalp and multiple cysts are common.
Tinea of vellus hair is diagnosed when the vellus hair is infected by a dermatophyte. They reported four patients and since then three other reports have yielded an additional seven patients with a condition which is histologically characteristic but shows some variation in clinical presentation. Facial variant of eruptive vellus hair cyst bhushan p. Calnan department of dermatology, the royal free hospital, pond street, london nw3 2qg accepted for publication 11 february 1980 history mr r. Eruptive vellus hair cysts evhc are unusual developmental abnormality of vellus hair follicles. Togawa y, takada s, wakabayashi s, kambe n, matsue h. Eruptive vellus hair cysts evhc are uncommon, benign. The condition affects males and females equally, and sporadic cases usually appear at 418 years of age. A clinical diagnosis of steatocystoma multiplex and chronic folliculitis was given, and a punch biopsy from the papule was performed and sent for histopathological. Histopathology showed a cyst in the dermis containing multiple, small vellus hair shafts along with the laminated keratinous material. Eruptive vellus hair cysts, international journal of. Steatocystomas and vellus hair cysts are closely related to each other. The vellus hair cyst was filled with keratinous material with unusual slit.
Evhc mostly develop as a consequence of occlusion of the infundibulum of vellus hairs with resultant cystic dilatation and retention of keratinous debris and vellus hairs. Eruptive vellus hair cysts evhcs were initially described in 1977 as papular chest and extremities eruptions in two paediatric cases. Lymphoepithelial cysts typically have an undulating luminal surface lined by stratified squamous epithelium. Eruptive vellus hair cyst evhc is a follicular disorder presenting as asymptomatic, papular lesions. The report of two patients in this paper is intended to further help clarify the clinical features.
These hairs are much shorter than normal, and their follicles do not have sebaceous glands. Pdf eruptive vellus hair cyst evhc is a rare follicular developmental abnormality of the vellus. Although surgical excision of the lesions was the recommended treatment, the patient refused such management to avoid postoperative scarring or keloid formation. Pdf dermoscopic findings in eruptive vellus hair cysts. Exceptions include the lips, the back of the ear, the palm of the hand, the sole of the foot, some external genital areas, the navel, and scar tissue. Follow up of the patient showed no progression of the disease over 2 years. Bayliss, md saint louis, missouri milia are frequently encountered as a primary or secondary patient concern in pediatric and adult clinics, and in general or surgical dermatology practice. Eruptive vellus hair cyst with laminated keratin and attenuated epithelial lining 12. Pdf eruptive vellus hair cysts are asymptomatic, fleshcoloredtobluish. Focal rupture of the cyst may occur with an associated giant cell reaction. Cysts 367 21 clinical images are available in hardcopy only. The literature suggests that evhcs could be a developmental abnormality of the vellus follicles or hamartoma of the pilosebaceous units. Numerous fleshcolored nodules on the trunk mdedge dermatology. Eruptive vellus hair cysts evhc were first reported by esterly et al in 1977.
We present this because of this patients unusual distribution of eruptive vellus hair cysts. Combined cutaneous hamartoma encompassing benign melanocytic. Histologically, these papules had the unique characteristic of dermal cysts containing small vellus hairs. Eruptive vellus hair cysts evhcs were first described in 1977 by esterly and colleagues who reported 2 children with symmetrically distributed follicular papules on the chest and flexor extremities. The hair bulb is located higher than most hair follicles, and follicle itself is not very deep.
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