Skin cysts: Difference between revisions

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[[File:Relative incidence of cutaneous cysts.jpg|thumb|Relative incidence of cutaneous cysts.<ref>Pakistan: {{cite journal|last1=Kamyab|first1=Kambiz|last2=Kianfar|first2=Nika|last3=Dasdar|first3=Shayan|last4=Salehpour|first4=Zahra|last5=Nasimi|first5=Maryam|title=Cutaneous cysts: a clinicopathologic analysis of 2,438 cases|journal=International Journal of Dermatology|year=2020|issn=0011-9059|doi=10.1111/ijd.14808}}</ref>]]
[[File:Relative incidence of cutaneous cysts.jpg|thumb|Relative incidence of cutaneous cysts.<ref>Pakistan: {{cite journal|last1=Kamyab|first1=Kambiz|last2=Kianfar|first2=Nika|last3=Dasdar|first3=Shayan|last4=Salehpour|first4=Zahra|last5=Nasimi|first5=Maryam|title=Cutaneous cysts: a clinicopathologic analysis of 2,438 cases|journal=International Journal of Dermatology|year=2020|issn=0011-9059|doi=10.1111/ijd.14808}}</ref>]]
{|class="wikitable"
{|class="wikitable"
! Location !! Main diagnoses
! Location !! Main diagnoses<ref name=Bolognia/>
|-
|-
! Face
! Face
Line 37: Line 37:
*Proliferating epidermoid (infundibular) cyst
*Proliferating epidermoid (infundibular) cyst
|-
|-
! Axilla and groin
|
*Steatocystoma
*Epidermoid cyst
|-
! Preauricular
|
*Ear pit cyst
*Epidermoid cyst
|-
! Upper gluteal cleft and sacrococcygeal area
|
*Pilonidal cyst
|}
|}
{{Bottom}}
===Non-stratified squamous epithelium===
===Non-stratified squamous epithelium===
{|class="wikitable"
! Location !! Main diagnoses<ref name=Bolognia/>
|-
! Face
|
*Hidrocystoma
:*Eccrine at lower eyelid and cheek
:*Apocrine at eyelid margin
|-
! Suprasternal notch
|
*Bronchogenic cyst (infants)
|-
! Midline anterior neck
|
*Thyroglossal duct cyst
|-
! Lateral neck, preauricular, mandibular
|-
*Brachial cleft cyst (teenagers and young adults)
|-
! Lower extremities
|
*Cutaneous ciliated cyst (young women)
|-
! Labia majora
|
*Ciliated cyst of the vulva
|-
! Ventral glans and penile shaft
|
*Median raphe cyst
|-
! Umbilical or periumbilical
|
*Omphalomesenteric duct cyst
|}


===Absence of epithelium (pseudocyst)===
{|class="wikitable"
! Location !! Main diagnoses<ref name=Bolognia/>
|-
! Oral mucosa
| Mucocele (lower labial)
|-
! Dorsal aspect of distal phalanx of finger or toe
|
*Digital mucous cyst/pseudocyst
|-
! Wrist
|
*Ganglion
|-
! Scaphoid fossa of the ear
|
*Pseudocyst of the auricle (adult men)
|-
! Sites of surgical trauma
|
*Cutaneous metaplastic synovial cyst/pseudocyst
|}


===Absence of epithelium (pseudocyst)===
==Diagnoses==
===Epidermoid cyst===
[[File:Histopathology of epidermoid cyst.jpg|thumb|Epidermoid cyst]]
Typical findings:<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/skintumornonmelanocytickeratinouscystepidermal.html|title=Skin nonmelanocytic tumor - Cysts - Epidermal (epidermoid) type|author= V. Claire Vaughan, M.D., Joshua Wisell, M.D.|website=pathology Outlines}} Topic Completed: 9 May 2019. Revised: 13 December 2019<7ref>
*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
{{Bottom}}

Revision as of 08:44, 4 March 2020

Author: Mikael Häggström [note 1]

Microscopic evaluation

The main initial clue is the lining of the cyst, being either stratified squamous epithelium, non-stratified squamous epithelium, or absence of epithelium (pseudocysts):[1]

Stratified squamous epithelium

File:Relative incidence of cutaneous cysts.jpg
Relative incidence of cutaneous cysts.[2]
Location Main diagnoses[1]
Face
  • Epidermoid cyst
  • Milium
  • Pigmented follicular cyst (men)
  • Dermoid cyst (along embryonic fusion planes such as lateral eyebrows in infants)
  • Verrucous cyst
Scalp
  • Epidermoid cyst
  • Trichilemmal cyst
  • Proliferating tricholemmal cyst
Trunk
  • Epidermoid cyst
  • Vellus hair cyst (chest)
  • Steatocystoma
  • Veruccous cyst
Pelvic, anogenital
  • Proliferating epidermoid (infundibular) cyst
Axilla and groin
  • Steatocystoma
  • Epidermoid cyst
Preauricular
  • Ear pit cyst
  • Epidermoid cyst
Upper gluteal cleft and sacrococcygeal area
  • Pilonidal cyst

Non-stratified squamous epithelium

  • Brachial cleft cyst (teenagers and young adults)
Location Main diagnoses[1]
Face
  • Hidrocystoma
  • Eccrine at lower eyelid and cheek
  • Apocrine at eyelid margin
Suprasternal notch
  • Bronchogenic cyst (infants)
Midline anterior neck
  • Thyroglossal duct cyst
Lateral neck, preauricular, mandibular
Lower extremities
  • Cutaneous ciliated cyst (young women)
Labia majora
  • Ciliated cyst of the vulva
Ventral glans and penile shaft
  • Median raphe cyst
Umbilical or periumbilical
  • Omphalomesenteric duct cyst

Absence of epithelium (pseudocyst)

Location Main diagnoses[1]
Oral mucosa Mucocele (lower labial)
Dorsal aspect of distal phalanx of finger or toe
  • Digital mucous cyst/pseudocyst
Wrist
  • Ganglion
Scaphoid fossa of the ear
  • Pseudocyst of the auricle (adult men)
Sites of surgical trauma
  • Cutaneous metaplastic synovial cyst/pseudocyst

Diagnoses

Epidermoid cyst

File:Histopathology of epidermoid cyst.jpg
Epidermoid cyst

Typical findings:<ref>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<7ref>

  • 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

Notes

  1. 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. 1.0 1.1 1.2 1.3 page 1917 in: Bolognia, Jean (2018) (in de). Dermatology . Philadelphia, Pa: Elsevier. ISBN 978-0-7020-6342-8. OCLC 1011508489. 
  2. 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:10.1111/ijd.14808. ISSN 0011-9059. 

Image sources