Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obervation Letter
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF
Letter to the Editor
2009:75:5;537-538
doi: 10.4103/0378-6323.55421
PMID: 19736455

Eruptive vellus hair cysts: An alternative diagnosing method

Ayse Serap Karadag1 , Ebru Cakir2 , Aylin Pelitli1
1 Department of Dermatology, Ankara Kecioren Research and Training Hospital, Ankara, Turkey
2 Department of Pathology, Atatrk Chest Diseases and Thoracic Surgery Centre, Ankara, Turkey

Correspondence Address:
Ayse Serap Karadag
Department of Dermatology, Ankara Kecioren Research and Training Hospital, Ankara
Turkey
How to cite this article:
Karadag AS, Cakir E, Pelitli A. Eruptive vellus hair cysts: An alternative diagnosing method. Indian J Dermatol Venereol Leprol 2009;75:537-538
Copyright: (C)2009 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Eruptive vellus hair cysts (EVHC) are unusual developmental abnormality of vellus hair follicles. [1] Diagnosis is generally made by clinical presentation and confirmed with punch biopsy and histological examination. Recently minimally painful or painless, nonscarring techniques have been described. [2] We report a 10-year-old girl diagnosed as EVHC with an alternative method.

A 10-year-old girl presented with generalized papular eruption. The skin lesions initially appeared on anterior chest two years ago and then spread to upper and lower extremities. The number of lesions gradually increased. She had no subjective symptoms. Her past medical and family history was unremarkable. Dermatological examination revealed multiple, smooth, soft, fresh colored, 1 to 3 mm, follicular papules on the anterior chest, upper and lower extremities [Figure - 1]. The rest of her cutaneous examination was within normal limits.

The clinical diagnosis of EVHC was made. The cysts were relatively superficial and therefore we attempted an alternative method to support the diagnosis. After local application of anesthetic cream containing lidocaine and prilocaine (EMLA® cream, Astra-Zeneca, Turkey) for an hour; a tiny incision was performed on the top of a lesion and cystic material was gently squeezed. Microscopic examination of the cystic material in a 10% potassium hydroxide preparation demonstrated numerous vellus hairs [Figure - 2]. A skin punch biopsy was performed to confirm the diagnosis. Histopathological findings demonstrated a cystic structure lined by squamous epithelium in the lower dermis. Vellus hairs and laminated keratinous materials were present within the cyst; no sebaceous structure was seen within the cyst wall [Figure - 3]. These findings were consistent with EVHC. The patient refused the mechanical treatment option so she was treated with topical tretinoin. There was no evidence of clinical improvement even after two months of the treatment.

EVHC presents on the chest and extensor or flexor surfaces of the extremities. The lesions have been described as skin colored macules or papules, ranging in size from 1 to 5 mm and numbering from 20 to 200. EVHC may be sporadic or be inherited in an autosomal dominant manner. [1],[2]

The clinical differential diagnosis includes steatocystoma multiplex, trichilemmal and dermoid cysts, comedones of acne, keratosis pilaris, perforating disorders, folliculitis, syringomas, milia, and molluscum contagiosum. [1],[3] Trichostasis spinulosa (TSS) is another important disorder in the differential diagnosis of EVHC. Protruding vellus cysts in TSS may be inapparent to naked eyes and the disease may clinically simulate EVHC. [4] Histological examination is essential to differentiate these similar skin lesions. [5]

Clinical presentation is usually diagnostic for EVHC but sometimes the diagnosis should be confirmed with punch biopsy and histological examination. Nevertheless, punch biopsy can be both distressing and painful, and may leave an unpleasant scar. [2] In the present case, we used an alternative method to support the clinical diagnosis. A similar technique was reported by Sardy and Karpati. The author utilized a sterile, large (18 Gx2) blood-collecting needle to aspirate cystic contents from anesthetized skin. [3] Recently Kaya et al. [5] reported a different technique, which is also used for treatment. After puncturing the overlying skin using the sharp-tipped cautery point, they grasped the base of the cyst using a standard dissecting forceps and they extracted the cysts out. [5] These techniques are less invasive methods than punch biopsy.

EVHC are usually asymptomatic lesions but treatment is necessary for cosmetic reasons. Spontaneous resolution can be seen in one-fourth of the patients because of transepidermal elimination. Topical (retinoic acid, 12% lactic acid, 10% urea), mechanical (cauterization, curettage, dermabrasion, CO 2 laser) and systemic (oral isotretinoin) treatment modalities are available. [1],[5]

References
1.
Reep MD, Robson KJ. Eruptive vellus hair cysts presenting as multiple periorbital papules in a 13-year-old boy. Pediatr Dermatol 2002;19:26-7.
[Google Scholar]
2.
Hong SD, Frieden IJ. Diagnosing eruptive vellus hair cysts. Pediatr Dermatol 2001;18:258-9.
[Google Scholar]
3.
Sardy M, Karpati S. Needle evacuation of eruptive vellus hair cysts. Br J Dermatol 1999;141:594-5.
[Google Scholar]
4.
Strobos MA, Jonkman MF. Trichostasis spinulosa: itchy follicular papules in young adults. Int J Dermatol 2002;41:643-6.
[Google Scholar]
5.
Kaya TI, Tataroglu C, Tursen U, Ikizoglu G. Eruptive vellus hair cysts: An effective extraction technique for treatment and diagnosis. J Eur Acad Dermatol Venereol 2006;20:264-8.
[Google Scholar]

Fulltext Views
294

PDF downloads
95
Show Sections