Steatocystoma multiplex

Steatocystoma multiplex, an uncommon condition, is often familial, demonstrating an autosomal dominant mode of inheritance. Although lesions can be discovered at any age, they most commonly occur shortly after puberty. The condition presents as multiple 1- to 2-cm cysts, generally located intradermally. They are most commonly found on the anterior chest, but they are also found on the face, forehead, ears, eyelids, and scalp. When punctured, these lesions exude a yellowish, oily fluid and, occasionally, hairs. On histologic examination, these cysts contain a highly corrugated wall ofepithelial cells. Embedded within the wall are multiple sebaceous gland lobules, which may be partially responsible for the contents of the cyst. The mode of keratinization of the epithelial lining appears to resemble that of the outer root sheath, and indeed invaginations are often present within the cyst wall that appear similar to hair follicles. Infection with pain and subsequent scarring is a major problem associated with this condition. Treatment is disappointing because of the large number of lesions present, although individual lesions can easily be excised. On the face, cosmetically acceptable improvement has been reported with excision, CO2 laser, dermabrasion, and oral retinoids


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