Steaocystoma Multiplex

Synonyms

Sebocystomatosis, Steatocystoma Multiplex Pringler

Definition

Steatocystoma multiplex is a typical disease, characterized by the presence of multiple cysts dermis, which contains sebum, and limited by the epithelium containing sebaceous follicles. Autosomal dominant inherited.

Epidemiology 

It usually begins at puberty or young adulthood. Men more often affected than women.

Etiology

Formerly considered a keratin or sebaceous cysts inclusion. Now steatocystoma considered a hamartoma and variant of the cyst or dermoid cyst vellus hair.

Clinical manifestations

Lesions can arise at birth or shortly afterwards. Cystic nodules appear clinically asymptomatic with soft consistency up hard, attached to the overlying skin, yellowish with surface smooth and when the lesion is punctured will discharge oily yellow like cheese. Its size varies, from a few mm to 3 cm, but rarely more than 1.5 cm. In general, the lesion is located in the sternum area, axillary arm, and scrotal area.

Histopathology 

In microscopic, cyst appear as layer of squamous epithelium without  granular layer. Cyst usually folded. Characteristics that appear as non cell layer thick form, eosinophilic, homogeneous, epithelial lining lumen side. Cyst wall often consists of adnexal structures primarily glandular sebaceous or abortive hair follicles. Cyst space can contain lanugo hair.

Differential diagnosis 

Dermoid cysts, epidermoid cyst multiple, Neurofirbomatosis, sebaceous adenoma, Lipoma.

Treatment

The best treatment is by excision. But because there are many, such methods sometimes can not be implemented. As an alternative incision and the contents of the cyst expression, but it is often cause recurrence after a few months

MILIUM

Definition: Milium a keratin cyst subepidermal small, especially occur on the face, especially periorbital. Originating from the epidermis or adnexal, may occur secaa primary or secondary.

Epidemiology: Often found in the parent, but may occur in infants newborn. More common in women than men.

Etiology: The cause of primary milia ridak known, is likely to come from pilosebaseus follicles. While the secondary milia common of retention cysts after various dermatoses, ascribed to the hair follicles, glands sweat, sebaceous glands or the epidermis.

Histopathology: microscopic description similar to the epidermal cyst, only different in size. On a serial pieces, with primary milium Velus appear to be associated with a hair follicle, while milium

Secondary appear to be associated with formation of epithelial stem.

Differential diagnosis: Pustular Acne, Molluskum contagiosum, Hyperplasia sebassa.

Treatment: Incision and contents milium expression. Prognosis: Milia are purely benign lesions and just cause cosmetic problems.

Trichilemmal Cyst

Synonyms: Kista pilaris, sebaceous cysts.

Definition: trichilemmal cyst is a cyst containing keratin, composed by an epithelium that resembles the outer root sheath of hair, can be derived autosomal dominant

Epidemiology: Usually appears in middle age. Women are more often affected than men.

Etiology: Wall cysts originating from outside the hair root sheath that surrounds the bottom of the hair follicle.

Manifesasi Clinic: basanya occurs on the scalp. Clinically difficult to distinguish from epidermal cysts, but these cysts dienukleasi easier and more keratinosa contents and not so fatty and less smelly than the content of epidermal cysts.

Histopathology: Looks restricted cyst wall several layers of cuboidal shaped epidermal cells are arranged palisade without granular layer and intercellular bridges. Epithelial cells bordering the cyst contents swell and contains pale cytoplasm. Cyst contents in the form of a homogeneous eosinophilic material.

Diagnosis: epidermal cysts, Cylindroma, Lipoma.

Treatment: Treatment for cysts trichilemmal is the same as epidermal cysts.

Prognosis: Good, rarely undergo malignant transformation.