Difference between revisions of "Dermal cysts"

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====Images====
====Images====
*[http://dermatlas.med.jhmi.edu/derm/IndexDisplay.cfm?ImageID=1982738883 Venous lake (jhmi.edu)].<ref name=jhmi_vl>URL: [http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=605386295 http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=605386295]. Accessed on: 13 August 2012.</ref>
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?s=20080802172033945 Venous lake (surgical pathologyatlas.com)].
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?s=20080802172033945 Venous lake (surgical pathologyatlas.com)].



Revision as of 17:18, 26 August 2016

Dermal cysts, also skin cysts, are common in dermatopathology. Dermatopathologists can diagnose 'em.

Overview

Common types:[1]

Epidermal necrosis

Common cysts

Venous lake

General

  • Dilated vein.

Clinical:

  • Blanch with pressure.[2]

Gross

  • Purple/blue spot.

Images:

Microscopic

Features:[4]

  • Lined by endothelium.
  • Blood in lumen.
  • +/-Fibrin in lumen.
  • +/-Solar elastosis - very common.[5]

DDx:

Images

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SKIN LESION, RIGHT CHEEK, BIOPSY:
- VENOUS LAKE.
- SOLAR ELASTOSIS.
- NEGATIVE FOR NEVUS.

Epidermal inclusion cyst

Pilar cyst

  • AKA trichilemmal cyst.

Dermoid cyst

General

Microscopic

Features:[6][7]

  • Cyst lined by normal (keratinized) skin with adnexal structure (hair follicles, sweat glands, sebaceous glands).

DDx:

Images:

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SKIN CYST, RIGHT LATERAL ORBIT, EXCISION:
- DERMOID CYST
- NEGATIVE FOR MALIGNANCY.

Pilonidal cyst

  • AKA pilonidal sinus.
  • AKA pilonidal disease.[8]

Less common

Steatocystoma

Digital mucous cyst

  • AKA digital synovial cyst.[9]
  • AKA digital myxoid pseudocyst.[9]

General

Microscopic

Features:[9]

  • Mucous in superficial dermis - key feature.
  • No epithelial lining; it is a pseudocyst.

Note:

  • Mucin = glycolated proteins; may be part of mucous.
  • Mucous = slippery secretion.
    • Some split hairs over the "u" - "mucus" vs. "mucous".[10][11]

DDx:

Images:

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LESION, LEFT INDEX FINGER, EXCISION:
- DIGITAL MUCOUS CYST.

Apocrine cystadenoma

General

  • Uncommon.

Microscopic

Features:[13]

  • Multiloculated.
  • Apocrine differentiation: columnar epithelium +/- apical snouts.
  • Solid areas of epithelial proliferation.
  • Papillary projections into the cyst.

Images:

See also

References

  1. Greenwald, J.; Heng, M. (2007). Toronto Notes for Medical Students 2007 (2007 ed.). The Toronto Notes Inc. for Medical Students Inc.. pp. D5. ISBN 978-0968592878.
  2. URL: http://dermatlas.med.jhmi.edu/derm/IndexDisplay.cfm?ImageID=-969536424. Accessed on: 13 August 2012.
  3. 3.0 3.1 URL: http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=605386295. Accessed on: 13 August 2012.
  4. Weedon's Skin Pathology. 3rd Ed. P.895.
  5. 5.0 5.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 551. ISBN 978-0443066542.
  6. 6.0 6.1 6.2 Gandhi N, Syed NA, Alen R. Dermoid Cyst. EyeRounds.org. posted July 26, 2010; Available from: http://www.EyeRounds.org/cases/115-dermoid-cyst.htm. Accessed on: 22 September 2011.
  7. Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 596. ISBN 978-1416054542.
  8. URL: http://emedicine.medscape.com/article/788127-overview. Accessed on: 10 September 2012.
  9. 9.0 9.1 9.2 9.3 URL: http://www.dermpedia.org/dermpedia-textbook/digital-mucous-myxoid-cyst. Accessed on: 17 January 2012.
  10. URL: http://dictionary.reference.com/browse/mucous. Accessed on: 8 January 2012.
  11. URL: http://dictionary.reference.com/browse/mucus. Accessed on: 8 January 2012.
  12. URL: http://www.dermpedia.org/case/digital-mucous-cyst-ganglion-type. Accessed on: 5 July 2013.
  13. Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 316. ISBN 978-0443066542.