bromochloroacetic-acid and Epidermal-Cyst

Epidermoid cysts of the body of the tongue are rare. Only 12 cases of such lesions have been reported in the English literature.. A 14-year-old boy had a 7×5-mm-sized cystic lesion with a yellowish-white surface on the ventral aspect of his tongue. The cystic wall was composed of squamous epithelium containing keratinous material. No skin appendages were attached to the wall. These findings were consistent with a diagnosis of an epidermoid cyst.. For the thirteen cases, including ours, the average age was 18.0 years. The highest incidence was found in the first decade of life. Eight of the patients were male and five were female. The size varied from several millimeters to several centimeters. There may be a left side predilection of the occurrence. There is no evidence for malignant transformation of epidermoid cysts of the tongue, though two cases were reported as carcinoma arising from an epidermoid or dermoid cyst of another oral area.. Epidermoid cysts of the body of the tongue are congenital or acquired. The congenital type can arise due to a failure of surface ectoderm separation or invagination of the surface ectoderm along the embryologic fusion sites. The acquired type is caused by trauma, with implanting of an epithelial element into the deeper tissue. In the present case, it was difficult to determine whether the pathogenesis was congenital or acquired because there are no clinical or histopathological differences between the two types.

Topics: Adolescent; Epidermal Cyst; Epithelium; Humans; Keratins; Male; Mouth Diseases; Tongue

This report is the first description of a spinal epidermoid cyst (EC) in a SJL mouse and gives an overview on the occurrence of ECs in animals including dogs, horses, mice and rats. The EC was not detected grossly and the mouse did not display clinical signs or an altered rotarod performance. Microscopically, there was an oval cyst lined by stratified squamous epithelium that was attached to the dorsolateral meninges and caused moderate compression of the adjacent lumbar spinal cord. ECs in mice and rats are mainly located in the caudal part of the spinal cord with a variable, strain-dependent occurrence. ECs in mice and rats are not associated with clinical signs and can be interpreted as incidental findings.

Topics: Animals; Central Nervous System Diseases; Dogs; Epidermal Cyst; Female; Incidental Findings; Keratins; Lumbar Vertebrae; Meninges; Mice; Mice, Inbred Strains; Motor Activity; Rats; Rodent Diseases; Species Specificity; Spinal Cord Compression

Intrapancreatic accessory spleen is a benign lesion that mimics hypervascular or cystic pancreatic neoplasm. A comprehensive clinicopathologic analysis has not yet been reported.. We described the clinicopathologic characteristics of 12 cases of pathologically proven intrapancreatic accessory spleen, among which 6 had internal epidermoid cysts. Immunohistochemistry was done to clarify the origin of epidermoid cysts.. Most cases were incidentally detected in young adults. Two-thirds of cases with intra-lesional cysts showed elevated serum carbohydrate antigen 19-9 levels. Radiologically, heterogeneously enhancing a solid portion similar to the spleen was a helpful, but not convincing, feature. Grossly, a well-circumscribed dark red mass with or without cysts in the pancreatic tail was characteristic. Microscopically, small foci of pancreatic tissue were embedded within the splenic tissue. Epidermoid cysts consisted of modified squamous epithelium, some of which had intracellular mucin. Cytologic smears showed large aggregates of benign spindle cells that were reactive against CD8. Immunohistochemical staining of the cystic epithelium suggested its pancreatic ductal origin.. Intrapancreatic accessory spleen with or without epidermoid cyst should be considered as differential diagnoses when well-enhanced solid or cystic tumors are found in the pancreatic tail. Radiologic suspicion and preoperative aspiration or biopsy might minimize the need for unnecessary surgery.

Topics: Adult; CD8 Antigens; Choristoma; Diagnosis, Differential; Epidermal Cyst; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Pancreatic Cyst; Pancreatic Diseases; Pancreatic Neoplasms; Spleen

Milia en plaque, a rare inflammatory plaque type of milia is generally located in the periauricular area. Bilateral retroauricular milia en plaque is very rarely reported. Here, we report another case of bilateral retroauricular milia en plaque and review the previous cases.

Topics: Adult; Biopsy; Ear, External; Epidermal Cyst; Erythema; Female; Humans; Keratins; Neck

Epidermal inclusion cyst is one of the common benign soft tissue tumors, and it can be easily confirmed and treated by surgical excision. We experienced a patient who had multiple masses on the face and scalp region, and the masses had been misdiagnosed as neurofibromatosis because of accompanying mental retardation. We would like to introduce a case of clinical diagnosis error caused by the lack of radiologic evaluation and pathologic confirmation. A 27-year-old male patient visited with multiple masses, with a length of approximately 1 to 10 cm on the face and scalp region. These mass have developed since childhood without known etiology, and there has been no histologic examination or surgical excision done in the past. The patient's history of seizure disorder and mental retardation led the primary clinician to diagnose it as neurofibromatosis in the initial stage, and therefore, the clinician gave an advice on the possibility of frequent recurrence to the patient. As the masses increased in size, the patient came to our hospital after all. We found that the masses were soft and mobile through the physical examination, and magnetic resonance imaging showed evidence of epidermal inclusion cyst, which is distinguished from neurofibromatosis. Based on physical examination and magnetic resonance imaging, we performed total excision and biopsies. On the histologic examination, it was diagnosed as an epidermal inclusion cyst showing keratotic material internally, and the cyst wall was composed of lamellate keratin. The follow-up period was 12 months, and a recurrence has not occurred. The wound was healed without any specific complication, and both the patient and the guardian were satisfied with the physical enhancement. We have observed a misdiagnosed case that was misconceived by the situation, accompanying mental retardation. Due to this misconception, any surgical treatment was not performed at all, and the symptoms eventually worsened as multiple huge epidermal inclusion cysts. We present this case with a brief review of literature.

Topics: Adult; Biopsy; Diagnosis, Differential; Epidermal Cyst; Epilepsy; Face; Follow-Up Studies; Humans; Intellectual Disability; Keratins; Magnetic Resonance Imaging; Male; Neurofibromatoses; Scalp Dermatoses

Topics: Adult; Antigens, CD34; CA-19-9 Antigen; Calbindin 2; Diagnosis, Differential; Epidermal Cyst; Epithelium; Humans; Keratins; Male; Pancreatic Cyst; Pancreatic Diseases; S100 Calcium Binding Protein G; Spleen; Tomography, X-Ray Computed

Primary intracranial squamous cell carcinoma is extremely rare, with most of the cases arising from malignant transformation of an epidermoid or a dermoid cyst. We report here a case of a 45-year-old male patient who presented with 1-month history of intermittent headache and recent onset of altered sensorium. Imaging revealed a midline posterior fossa mass lesion compressing the fourth ventricle and causing hydrocephalus. A provisional diagnosis of dermoid cyst was considered. Histopathological examination revealed a squamous cell carcinoma possibly arising from an underlying epidermoid cyst. This entity is being reported for its rarity.

Topics: Brain Diseases; Calcinosis; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Cholesterol; Cranial Fossa, Posterior; Diagnosis, Differential; Epidermal Cyst; Fourth Ventricle; Humans; Keratins; Male; Middle Aged; Skull Base Neoplasms; Tomography, X-Ray Computed

Epidermoids occurring within the lateral ventricles are rare. At one time, they were regarded as anatomical curiosities. The lesions are of developmental aetiology, due to migration of epiblast inclusion at the time of formation of the cerebral vesicle. They are slow growing, and presentation is non-specific in the form of deteriorating mental functions. Generally seen in the fifth decade, but they have also been observed in the paediatric age group. MRI is suggestive of a cystic lesion, and is confirmed to be a typical epidermoid within the lateral ventricle at operation, often having a connection to the midline through the choroidal fissure. The cysts should be excised with no additional morbidity. Histopathology reveals typical stratified squamous epithelium.

Topics: Brain Neoplasms; Cerebrospinal Fluid Pressure; Cerebrospinal Fluid Shunts; Cholesterol; Cognition Disorders; Disease Progression; Epidermal Cyst; Epithelial Cells; Headache; Humans; Keratins; Lateral Ventricles; Magnetic Resonance Imaging; Male; Middle Aged; Neurosurgical Procedures; Telencephalon; Treatment Outcome

A 42-year-old man presented with painful toenails which were overcurved transversely and onycholytic. Examination revealed that all toenails, the thumbs and index fingers were similarly affected. In addition, he had a small area of leukokeratosis in the mouth, epidermal cysts of the scrotal skin and a small area of hyperkeratosis on the ulnar borders of his hands. His characteristic nail changes began in the great toenails at the age of 20 years. After renal transplantation at age 39, the other nails changed and he developed the features described above. His sister has overcurvature of the fifth toenails. A diagnosis of pachyonychia congenita tarda was made. His case is compared with 14 other reported cases of this rare syndrome.

Topics: Adult; Age of Onset; Epidermal Cyst; Genetic Predisposition to Disease; Humans; Keratins; Kidney Transplantation; Leukoplakia, Oral; Male; Nails, Malformed; Scrotum; Syndrome

Epidermal inclusion cysts often occur as a result of traumatic implantation of epidermal cells into dermal tissue. The epidermal cells within the dermis can continue to grow and lead to the production of a lipid- and keratin-filled cyst, which can erode into bone and adjacent tissues. The authors present a case of bilaterally symmetrical epidermal inclusion cysts that occurred separately over a 10-year period. A brief review of the literature is also presented.

Topics: Adult; Epidermal Cyst; Foot Diseases; Foreign-Body Reaction; Giant Cells; Humans; Keratins; Male; Time Factors

Cutaneous ciliated cysts of the lower limb are rare. Almost exclusively occurring in women they have been widely regarded as Müllerian heterotopias. A second case in a man is reported, the literature reviewed and the origin of this lesion briefly discussed.

Topics: Actins; Adult; Carcinoembryonic Antigen; Epidermal Cyst; Foot; Humans; Keratins; Male; Membrane Glycoproteins; Mucin-1; Mucins; S100 Proteins

Approximately 700 cases of keratinizing cystic squamous lung lesions in rats were investigated by light microscopy in order to clarify the nomenclature and classification of these lesions. The structure of benign keratinizing cystic squamous cell tumours of the lung was compared to that of cystic squamous lesions in the skin of rats, with consideration of data from the literature. We conclude that the reviewed keratinizing cystic squamous cell lesions of the lung are true neoplasms and that the growth pattern of these cystic lesions is inconsistent with that of a simple cyst. In the development of squamous lung cancer, a continuum of proliferation from exaggerated metaplasia through benign cystic tumours to invasive squamous cell carcinomas can be observed.

Topics: Animals; Epidermal Cyst; Keratins; Keratoacanthoma; Lung Neoplasms; Rats; Skin Diseases; Terminology as Topic

A 6-year-old Caucasian girl had dozens of asymptomatic, flesh-colored, 2- to 5-mm eruptive vellus hair cysts. These papules on the buttocks, thighs, and groin increased in number for three months. Histologic examination revealed poorly defined, keratin-filled cysts in the upper middermis, containing numerous transversely or obliquely cut portions of vellus hair. The histopathologic differential diagnosis with other epithelial cysts containing hair shafts is debated, and new clinical differential diagnoses are proposed. Review of the literature suggests that eruptive vellus hair cyst is not a rare disorder, but its frequency is probably underestimated due to paucity of symptoms. Nevertheless, the clinical relevance of some of the differential diagnoses should convince clinicians to obtain histologic confirmation.

Topics: Buttocks; Child; Epidermal Cyst; Epithelium; Female; Groin; Hair; Humans; Keratins; Skin Diseases; Thigh

The nomenclature and pathogenesis of cutaneous cysts is discussed along the lines of their pathological properties. On the basis of histological and experimental evidence it is concluded that most cysts represent benign neoplasms derived from pluripotential cells.

Topics: Adenoma, Sweat Gland; Cysts; Dermoid Cyst; Epidermal Cyst; Hamartoma; Humans; Keratins; Pilonidal Sinus; Skin Diseases; Skin Neoplasms; Sweat Gland Diseases

Topics: Epidermal Cyst; Humans; Keratins; Lip; Lip Diseases; Male; Middle Aged

Punctal keratin cyst (PKC) is a rare disorder believed to be due to ectasia of the vertical canaliculus. The etiopathogenesis of this disorder is very poorly understood due to the paucity of literature. To the best of authors' knowledge, only two cases of punctal keratin cyst have been described earlier, which presented as cystic lesions. The authors report four cases of punctal keratin cyst which differ in clinical presentation and also describe the anterior segment ocular tomography features, which aids in recognition and diagnosis of this rare disorder. The key message of the article is that lack of a defined cyst on clinical examination and optical coherence tomography (OCT) cannot rule out the presence of a PKC. A combination of clinical, radiology, and histopathology are confirmative of the diagnosis. Once diagnosed, the subsequent outcomes with membranotomy and keratin curettage are excellent.

Topics: Aged; Epidermal Cyst; Eyelids; Female; Humans; Keratins; Lacrimal Apparatus; Rare Diseases; Tomography, Optical Coherence

Phyllodes tumor (PT) is a fibroepithelial lesion of breast known for presence of a heterogenous stroma. However occurrence of a keratin cyst within PT is a rare incidence. An inadequate sampling during fine needle aspiration (FNA) of such lesions may result in an erroneous cytological diagnosis.. In the present case, ultrasound guided FNA smears from the breast lump in a 31-year-old lady with a clinical suspicion of malignancy, were repeatedly interpreted as an epidermal inclusion cyst, which was ultimately reported as a borderline PT on mastectomy.. The case report aims at highlighting the importance of a diligent FNA technique keeping in mind the possibility of the various uncommon lesions especially while dealing with such a heterogenous tumor as phyllodes.

Topics: Adult; Biopsy, Fine-Needle; Breast; Epidermal Cyst; Female; Humans; Keratins; Phyllodes Tumor

Trichoblastic infundibular cyst (TBIC) was previously reported as a unique keratinous cystic lesion, which was characterized by the papillary projections of follicular germinative-like cells emanating from the cyst wall. Here, we report three additional cases of this cyst and discuss the pathogenesis of this unique entity. In all cases, a unilocular cyst contained keratin, and the cyst wall was composed of squamous epithelium. A number of cords and papillary projections emanated from the basal layer of the cyst wall. They were composed of cells with large nuclei and scant cytoplasm arranged in a peripheral palisade. Immunohistochemically, anti-cytokeratin 15, anti-cytokeratin 20, and anti-epithelial cell adhesion molecule antibodies were negative. Thus, these cells resembled follicular germinative cells or sebaceous mantle morphologically, but we failed to prove the differentiation immunohistochemically. The cyst was surrounded by fibrotic stroma and inflammatory cells, suggesting previous rupture of the cyst. We speculate that the cells of the projections possibly differentiate into the mantle rather than follicular germinative cells, even though we could not provide sufficient immunohistochemical evidence. We also suggest that they may be induced by special reaction to fibrohistiocytic stroma surrounding the infundibular cyst. Therefore, TBIC should be renamed infundibular cyst with unique papillary projections.

Topics: Adult; Aged; Asian People; Diagnosis, Differential; Epidermal Cyst; Follicular Cyst; Hair Follicle; Humans; Immunohistochemistry; Keratins; Male; Margins of Excision; Middle Aged; Skin Neoplasms

Epidermoid cysts of the spinal cord may rupture, resulting in keratin dissemination in the subarachnoid space, in the ventricles, and along the central canal of the spinal cord causing meningitis, myelopathic changes, or hydrocephalus.. A 53-year-old woman with no past medical history presented with a 2-week history of headache located in the occipital region associated with neck pain. Brain magnetic resonance imaging demonstrated multiple fat droplets scattered throughout the subarachnoid and intraventricular spaces with significant edema of the right posterior temporoparietal lobes with trapping of the right temporal horn of the lateral ventricle and atrium. An intracranial lesion could not be observed in the study. The spinal region was suspected as the possible culprit, and spinal imaging showed a large cystic lesion at the level of the conus medullaris. The patient underwent neuronavigation endoscopic exploration of the right lateral ventricle with flushing of the keratin particles followed by a posterior lumbar decompression with resection of the epidermoid cyst. Pathology was consistent with an epidermoid cyst. Successful recovery with improvement in symptoms was quickly observed.. When an epidermoid cyst is suspected but no intracranial lesion is found, the intraspinal area should be studied. Rupture of a spinal epidermoid cyst may cause meningitis and inflammation producing obstructive hydrocephalus. We present this rare entity and describe the diagnostic and surgical techniques used.

Topics: Cerebral Ventricles; Decompression, Surgical; Endoscopy; Epidermal Cyst; Female; Humans; Hydrocephalus; Keratins; Magnetic Resonance Imaging; Meningitis; Middle Aged; Neuronavigation; Neurosurgical Procedures; Rupture; Spinal Diseases; Subarachnoid Space; Treatment Outcome

Topics: Epidermal Cyst; Eyelid Diseases; Female; Humans; Keratins; Meibomian Glands; Middle Aged; Ophthalmologic Surgical Procedures

Topics: Animals; Biopsy, Fine-Needle; Dog Diseases; Dogs; Epidermal Cyst; Female; Foot Diseases; Hoof and Claw; Keratins

PurposeMeibomian gland ductal cysts (MGDCs) and steatocystomas are epithelial lined, keratin-containing lesions of the eyelids. MDGCs are variably called tarsal keratinous cysts, intratarsal keratinous cysts of the meibomian glands, intratarsal inclusion cysts, epidermal cysts and epidermoid cysts. Both lesions are poorly described in the literature. We report a series of seven MGDC and steatocystomas, and examine their clinical, pathological and immunohistochemistry features and their management and outcomes.Patients and methodsA retrospective review of case notes and histopathology slides of all MGDCs and steatocystomas identified at one major histopathology service in South Australia between 2013 and 2015.ResultsSeven cases were identified, with an average age of 64. The lesions range from 4 to 18 mm diameter and are firm, well-circumscribed and non-tender, and sometimes the keratin-filled cyst protrudes visibly under the tarsal conjunctiva. Two cases were previously misdiagnosed as chalazia but recurred after incision and curettage. Histologically, these lesions are lined by squamous epithelium but lack a well-formed stratum granulosum and can be distinguished by their immunohistochemical staining characteristics. Complete excision, including a wedge of underlying tarsal plate for MDGCs, is curative for with a follow up of 12-36 months.ConclusionsMGDCs and steatocystomas should be included in the differential of benign eyelid lesions. Diagnosing and differentiating these lesions from chalazia is important for determining the optimal management strategy.

Topics: Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Epidermal Cyst; Eyelid Diseases; Eyelids; Female; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Male; Meibomian Glands; Middle Aged; Retrospective Studies; Sebaceous Gland Diseases

A facial sebaceous cyst is a common benign epithelial tumor and surgical excision is frequently performed but may cause obvious scarring and may be esthetically troubling.. This study evaluated the clinical outcomes of the patients with facial sebaceous cyst enucleated by creating minimal elliptical incisions through a keratin-filled orifice.. Eleven patients with facial sebaceous cyst enucleated by creating minimal elliptical incisions through a keratin-filled orifice. We treated nine male and two female patients aged 25-52 years. The mean cyst size was 1.85 × 1.56 cm.. All cysts were successfully enucleated. The mean wound length was 0.93 cm. The mean operative time was 15.2 min. The mean follow-up duration was 41.5 months. No recurrence was noted, and all patients were very satisfied with their esthetic outcomes. All cysts were successfully enucleated. The mean elliptical wound length was 0.93 cm (range, 0.8-1.1 cm). The mean operative time was 15.2 min. We found no evidence of wound infection, or nerve or vascular injury.. Enucleation of facial sebaceous cyst via a minimal elliptical incision through the keratin-filled orifice was associated with high-level patient satisfaction, and the method is safe and useful for treating facial epidermoid cysts.

Topics: Adult; Dermatologic Surgical Procedures; Epidermal Cyst; Facial Dermatoses; Female; Humans; Keratins; Male; Middle Aged; Operative Time; Patient Satisfaction; Retrospective Studies; Treatment Outcome

Topics: Aged; Biomarkers, Tumor; Biopsy; Cell Differentiation; Diagnosis, Differential; Epidermal Cyst; Humans; Keratins; Male; Neoplasms, Basal Cell; Skin Neoplasms

A 30-year-old man presented with lesions on his oral mucosa and soles. There were no similar complaints in his family members. The dermatological examination revealed follicular hyperkeratosis on his trunk and upper extremities and flesh-colored, firm cystic lesions on his axillae. He had focal, painful, hyperkeratotic areas sited particularly on both his soles and palms. In addition to these, leukokeratosis and ulcerative areas on buccal, labial mucosa, tongue, and at corners of the mouth, and complete loss of teeth was observed. The proximal layering was revealed on all of his nails. The laboratory investigations produced normal results except the deficiency of immunoglobulin A. The psychiatric examination revealed mild mental retardation. Keratin gene (KRT6a, KRT6b, KRT16, and KRT17) mutations for pachyonychia congenita were negative. He got removable dental prosthesis because of inadequate alimentation. Squamous cell cancer developed on lower lip mucosa during follow-up. We present an individual who had different nail dystrophy, epidermal cysts, mental retardation, blepharitis, complete loss of teeth, and negative keratin gene mutations for pachyonychia congenita and developed squamous cell cancer on the oral leukokeratosis lesions. We think that the present case may be an unusual new type of pachyonychia congenita.

Topics: Adult; Carcinoma, Squamous Cell; Epidermal Cyst; Humans; Intellectual Disability; Keratins; Keratosis; Leukoplakia, Oral; Lip Neoplasms; Male; Mouth, Edentulous; Oral Ulcer; Pachyonychia Congenita; Syndrome

Topics: Epidermal Cyst; Eye Infections, Bacterial; Eyelid Diseases; Female; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Keratins; Middle Aged

Scrotal calcinosis is a rare and benign condition characterized by multiple calcific deposits occurring in scrotum and formed as nodules and lumps within scrotal skin with any systemic metabolic disorder. The so-called idiopathic scrotal calcinosis does not appear to be idiopathic, but rather a process of dystrophic calcification of epidermal cysts. Histological examination shows calcium deposites with in the dermis that may be surrounded with histiocytes and an inflammatory giant cell reaction. The aim of this paper was to detect dystrophic calcification of epidermal cysts and to take attention to the incorrect terminology of "idiopathic calsification".. This is a two-centered study of scrotal calcinosis with 17 cases, on which clinical and histopathological examinations were conducted.. The patients we examined all had scrotal epidermoid cysts in varying stages of inflammation coexisted with scrotal calcinosis. Some cyts (52.9%) had intact epithelial walls, others (35.2%) showed rupture of their epithelial walls associated with the presence of keratin fibers and calcium granules in the surrounding dermis and all had naked calcium deposits lying in the dermis.. The spectrum of the changes that we experienced in the histology, coupled with the normal values in the biochemical profile, shore up the theory of dystrophic calcification of epithelial cysts. During the time first these cysts become inflamed than rupture in the and calcium depocytes replase with the cysts.

Topics: Adult; Aged; Aged, 80 and over; Calcinosis; Calcium; Epidermal Cyst; Genital Diseases, Male; Humans; Inflammation; Keratins; Male; Middle Aged; Retrospective Studies; Scrotum; Terminology as Topic; Young Adult

Six cases of eruptive vellus hair cysts (EVHC) were evaluated for histopathology and the immunohistochemical profile of Ki-67 and four keratins (K10, K14, K17 and K19). The pathological hallmark of EVHC was the existence of vellus hair shafts within the cystic cavity, but atypical pathological changes included two or three cysts and a foreign-body granuloma in three cases. Our results demonstrate that atypical pathological changes are not uncommon in EVHC, and indicate that based on keratin expression, it is likely that EVHC is derived from the infrainfundibulum and sebaceous duct.

Topics: Adolescent; Adult; Epidermal Cyst; Female; Hair Diseases; Humans; Keratinocytes; Keratins; Male; Middle Aged; Skin Diseases; Young Adult

Topics: Biomarkers; Chalazion; Diagnosis, Differential; Epidermal Cyst; Eyelid Diseases; Female; Humans; Keratins; Middle Aged

Topics: Aged; Cell Proliferation; Epidermal Cyst; Epithelial Cells; Female; Follicular Cyst; Hair Diseases; Humans; Keratins

Topics: Epidermal Cyst; Hair; Humans; Keratins; Male; Middle Aged; Scalp; Suture Techniques; Sutures

Multiple epidermoid cysts were observed microscopically in the testis of a New Zealand White rabbit. The cysts were lined by stratified squamous keratinizing epithelium and filled with concentric layers of keratin. Testicular epidermoid cysts have been described in men but are very rare in animals.

Topics: Animals; Epidermal Cyst; Keratins; Male; Rabbits; Testicular Diseases

The pathogenesis of nonparasitic splenic cysts (NPSCs) has not been clarified completely. The aim of this multinational and multicentre retrospective study was to further elucidate the origin of NPSCs.. From 1980 to 2006, 50 children and adolescents were surgically treated for NPSC at six paediatric surgical centres in four European countries. The initial histology report of 35 NPSCs, 22 epidermoid cysts, 11 pseudocysts or post-traumatic cysts and two mesothelial cysts was available. Additional re-evaluation, including immunohistochemistry, to detect cytokeratin, carcino-embrionic antigen and mesothelioma antibody in the inner surface of the cysts was carried out. Special attention was given to the possibility of preceding trauma to the splenic area and whether it played a role in the genesis of NPSC.. The pathological re-evaluation showed 30 epidermoid cysts, four mesothelial cysts and one pseudocyst. Immunohistology revealed eight epidermoid and two mesothelial linings of the cysts in those 11 patients in whom pseudocyst was diagnosed originally. No pseudocyst was documented in those patients who had a history of previous blunt abdominal trauma but was not proved by ultrasound and computed tomography scan.. In contrast with the prevailing belief, it has been demonstrated that NPSCs are congenital in origin, and there is no clinically proven evidence that trauma does play a role in their genesis.

Topics: Adolescent; Biomarkers; Biomarkers, Tumor; Child; Child, Preschool; Cysts; Epidermal Cyst; Female; Humans; Infant; Keratins; Male; Retrospective Studies; Spleen; Splenic Diseases

Seborrheic inclusion cyst (SIC) is a very rare variant of epidermal cyst of the skin. SIC shows seborrheic keratosis (SK)-like lesion in epidermal cyst. SIC is extremely rare; only 6 case reports have been published in the English literature. However, no immunohistochemical study of SIC has been reported. A 41-year-old Japanese man noticed a subcutaneous tumor in the neck. Physical examination showed slightly mobile tumor in the subcutaneous tissue, and total excision was performed. Grossly, the tumor (1 x 1 x 0.8 cm) was cyst containing atheromatous keratin. Microscopically, the lesion is a cyst containing keratins. About one half of the cyst showed features of epidermal cyst consisting of mature squamous epithelium with granular layers. The other one half showed SK-like epidermal proliferation. The SK-like area showed basaloid cell proliferation with pseudohorn cysts. No significant atypia was noted. Many eosinophilic cytoplasmic inclusion bodies were noted in the SK-like area. Immunohistochemically, the SK-like area was positive for pancytokeratin AE1/3, pancytokeratin CAM5.2, p63, and Ki-67 (labeling=8%) and HPV, but negative for p53. The pathological diagnosis was SIC.

Topics: Adult; Antigens, Viral; Biomarkers; Epidermal Cyst; Humans; Inclusion Bodies; Keratins; Keratosis, Seborrheic; Ki-67 Antigen; Male; Membrane Proteins; Papillomaviridae; Skin

Topics: Adult; Ankle; Biopsy; Crystallization; Epidermal Cyst; Humans; Keratins; Magnetic Resonance Imaging; Male; Microscopy, Polarization; Suction; Ultrasonography

Keratinization is a kind of cell death called terminal differentiation and includes various patterns such as epidermal keratinization (EK), trichilemmal keratinization (TK), and shadow cell differentiation (SCD), whereas these have not been comparatively investigated from a standpoint of cell death. In the present study, surgically extirpated specimens of epidermal cyst, trichilemmal cyst, and pilomatricoma (10 cases in each) were subjected to immunohistochemistry for single-strand DNA (ssDNA), gamma-H2AX, cleaved caspase-3, cleaved lamin A, caspase-14, and CD138 to compare the modes of cell death and keratinization pattern. Transitional cells in pilomatricoma were immunoreactive, although not in whole part, for ssDNA and gamma-H2AX, and negative for cleaved caspase-3 and cleaved lamin A. Epidermal and trichilemmal cyst were negative for these 4 markers, except for ssDNA or cleaved lamin A in a small number of parakeratotic cells in a few cases. The keratinizing component showed caspase-14(+)/CD138(-) in epidermal cyst, caspase-14(-)/CD138(+) in trichilemmal cyst, and caspase-14(-)/CD138(-) in pilomatricoma. These results indicate that EK, TK, and SCD have a common property of apoptosis-like programmed cell death without caspase-3 activation or nuclear fragmentation. Meanwhile, they show different characteristics one another as follows: (A), DNA double-strand breaks occur in the transitional cells of SCD but not in EK/TK; and (B), EK, TK, and SCD can be distinguished by expression pattern of caspase-14 and CD138 in the keratinizing component.

Topics: Biomarkers, Tumor; Caspase 14; Cell Death; Cell Differentiation; DNA Breaks, Double-Stranded; Epidermal Cyst; Hair Diseases; Humans; Immunohistochemistry; Keratins; Pilomatrixoma; Skin Diseases; Skin Neoplasms; Syndecan-1

Intratarsal keratinous cyst of the meibomian gland is a recently described entity that recurs if not completely excised. Herein, we report 2 cases and discuss their diagnosis and management: (1) A 57-year-old man with a recurrent mass of the upper eyelid treated with incision and drainage as a chalazion for more than 5 years and (2) An 85-year-old man presented with a slow growing nodule of the upper eyelid. Exploration via the eyelid crease approach revealed cysts fixed to the tarsus that were completely excised with a portion of the anterior tarsus. Histologically, these cysts exhibited a keratinizing squamous epithelium without a granular layer (trichilemmal keratinization), were lined by an eosinophilic undulating cuticle, contain string-like keratin debris, and had a fibrous wall without sebaceous lobules. All epithelial components strongly expressed high-molecular weight keratins, whereas the lining, cuticle, and keratin contents strongly expressed carcinoembryonic antigen. No recurrence has occurred 7 and 12 months postoperatively. The location and clinicopathologic findings of intratarsal keratinous cysts distinguish it from sebaceous tumors, steatocystoma simplex, epidermoid cyst, and dermoid cyst. However, like steatocystomas, intratarsal keratinous cysts exhibit a sebaceous duct phenotype. The anterior lid crease approach with partial tarsectomy seems to be an effective treatment.

Topics: Aged, 80 and over; Epidermal Cyst; Eyelid Diseases; Humans; Keratins; Male; Meibomian Glands; Middle Aged; Sebaceous Gland Diseases; Treatment Outcome

Epidermoid cyst of the external auditory canal (EAC) is rarely encountered in the clinical practice, but when it occurs, it may cause obstruction of the meatus that necessitates surgical excision. The aims of this study were to present 9 pediatric patients with epidermoid cysts of the EAC and to evaluate the outcome of the surgical technique that has been used in excision. Surgical removal of the cyst was carried out through a simple transmeatal approach, a medially based rectangular skin flap was elevated and the cyst was completely removed. No complications or recurrence have been reported. Epidermoid cyst should be listed in the differential diagnosis of EAC masses; it appears on computed tomography as a cystic mass in the outer cartilaginous part of EAC that is usually limited to the soft tissue with no bone erosion. It can be removed easily through simple transmeatal approach with high success rate and no morbidity.

Topics: Child; Child, Preschool; Diagnosis, Differential; Dissection; Ear Canal; Ear Diseases; Epidermal Cyst; Female; Follow-Up Studies; Humans; Keratins; Male; Retrospective Studies; Surgical Flaps; Suture Techniques; Tomography, X-Ray Computed; Treatment Outcome

Epidermoid cysts are rare, slow-growing, benign, developmental cysts that are derived from abnormally situated ectodermal tissue. Epidermoid cysts may grow anywhere on the body and about 7% of them are located in the head and neck. In literature, very few epidermoid cysts have been reported in the temporal region. Histopathologically, they are lined with plain stratified keratin-producing squamous epithelium, although in some cases part of the lining is made up of mucous secreting and ciliated epithelium. This may suggest an endodermal rather than an ectodermal origin. We present and discuss the management of a patient presenting a posttraumatic epidermoid cyst of the temporal region.

Topics: Adult; Biopsy, Fine-Needle; Epidermal Cyst; Epithelium; Fascia; Fasciotomy; Follow-Up Studies; Humans; Keratins; Magnetic Resonance Imaging; Male; Muscular Diseases; Temporal Muscle

Interosseous epidermoid cysts of the phalanges are rare, particularly at the base of the phalanx and if the lesion is tender. We report a case of a tender interosseous epidermoid cyst at the base of the distal phalanx of a young man.

Topics: Adult; Diagnosis, Differential; Epidermal Cyst; Finger Phalanges; Foreign-Body Reaction; Humans; Keratins; Male; Osteomyelitis; Radiography; Wounds, Penetrating

Topics: Epidermal Cyst; Filaggrin Proteins; Hair Diseases; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratins; Male; Pilomatrixoma; Skin Neoplasms; Young Adult

Topics: Aged; Diagnosis, Differential; Epidermal Cyst; Facial Neoplasms; Filaggrin Proteins; Hamartoma; Humans; Intermediate Filament Proteins; Keratins; Male; Sebaceous Glands; Skin Diseases

Pleomorphic adenoma (PA) is a rare tumor of the skin that may arise from either the apocrine or the eccrine glands. Only 4 cases of PA in the auricle have been reported. We experienced the case of a 40-year-old woman who had a slowly growing, nontender auricle mass for 3 years. Under a clinical diagnosis of an epidermal inclusion cyst, we performed a total excision of the tumor with the skin and with direct closure. No recurrence was found during the 18 months of postoperative follow-up. Histologic examination confirmed a diagnosis of PA. Hematoxylin-eosin stain showed tubules that were lined with 2 layers of epithelial cells. The stroma was composed of the myxoid and chondroid matrices. Immunohistochemical staining was positive for cytokeratin, epithelial membrane antigen, and gross cystic disease fluid protein, whereas it was negative for S-100 and carcinoembryonic antigen. These findings suggested that this tumor originated from the apocrine glands. Only a few cases of PA in the auricle have been reported in the literature, 2 of which occurred in the helical rim. Recurrence is rare if there is complete resection of the tumor along with the surrounding capsule. We report herein a rare case of PA that developed in the auricle.

Topics: Adenoma, Pleomorphic; Adult; Biomarkers, Tumor; Carrier Proteins; Cyst Fluid; Diagnosis, Differential; Ear Auricle; Ear Diseases; Ear Neoplasms; Epidermal Cyst; Epithelial Cells; Female; Follow-Up Studies; Glycoproteins; Humans; Keratins; Membrane Transport Proteins; Mucin-1

Topics: China; Epidermal Cyst; Female; Humans; Keratins; Male; Mutation, Missense; Pedigree

We present a 65-year-old man with a giant epidermal cyst extending from sole to dorsum of the foot by penetrating the interosseous muscles. This epidermal cyst extending from the sole to the dorsum of the foot was big and an extremely rare lesion.

Topics: Aged; Epidermal Cyst; Foot Diseases; Granuloma; Humans; Keratins; Magnetic Resonance Imaging; Male; Muscle, Skeletal; Skin

Topics: Adult; Epidermal Cyst; Female; Forehead; Humans; Keratins; Skin Diseases

Scrotal calcinosis is a rare disorder characterized by multiple papules or nodules of calcification in the scrotal skin. The etiology of this entity is speculative largely as a result of the paucity of larger series.This study of 20 patients with scrotal calcinosis was undertaken to critically analyze the histology with a view to assess the probable etiology of this lesion. Two thirds of the patients were young adults. Of these, 11 patients (55%) were asymptomatic and 9 complained of symptoms related to the breakdown of these lesions (eg, discharge, itching, or heaviness in the scrotum). All cases showed classical histologic features of scrotal calcinosis with a variable amount of calcification in the dermis. In 14 cases the etiology of this calcification could be traced to originate from dilated epidermal cysts. The spectrum of changes probably started with the cystic dilation of the hair follicle, then calcification around and within this cyst. Finally the epithelial elements disappeared, leaving behind residual areas of calcification. The remaining 6 cases did not have epithelial cysts in the vicinity. Based on these observations we conclude that scrotal calcinosis results from calcification of hair follicular or epidermal cysts, but as most of the cases report, this epithelium disappears and may not be seen.

Topics: Adult; Calcinosis; Disease Progression; Epidermal Cyst; Genital Diseases, Male; Hair Diseases; Hair Follicle; Humans; Immunohistochemistry; Keratins; Male; Scrotum; Skin Diseases

Topics: Anus Diseases; Diagnosis, Differential; Epidermal Cyst; Follicular Cyst; Hair Follicle; Humans; Keratins; Male; Middle Aged; Nevus, Pigmented

To report a case of proliferating trichilemmal cyst in a 55-year-old woman.. Observational case report.. A 55-year-old woman sought treatment for a mass in the right upper eyelid. The lesion was excised twice previously, and recurred. The mass was reexcised and examined histopathologically.. Light microscopy showed a cystic lesion lined by stratified squamous epithelium with a compact layer of eosinophilic keratin without granular cell layer. There was no atypia, mitosis, or stromal invasion.. Although proliferating trichilemmal cyst shows benign histopathologic features, clinical manifestations may mimic those of more aggressive tumors with local recurrences or distant metastasis. Wide excision of the lesion and close long-term follow-up is recommended.

Topics: Cell Proliferation; Eosinophils; Epidermal Cyst; Eyelid Diseases; Female; Humans; Keratins; Middle Aged; Mitosis; Skin Diseases

Syringomatous carcinoma (SC) has typically been observed in middle-aged and older patients. We report a case of SC mimicking an epidermoid cyst in a 23-year-old Asian man. Histopathologic examination results showed a dermal neoplasm consisting of nests of basaloid cells, focal areas of ductal differentiation, moderate dermal fibrosis, and moderate nuclear atypia consistent with a diagnosis of SC. No perineural involvement was noted. Results of 2005. immunohistochemical analysis revealed positivity for high- and low-molecular-weight cytokeratins, as well as for carcinoembryonic antigen (CEA). There was scattered immunoreactivity to S-100 protein. The tumor was completely excised Pennsylvania. using Mohs micrographic surgery (MS). This case demonstrates the importance of differentiating SC from other benign or malignant entities, the value of a prompt diagnosis of SC, and the effective treatment of SC with MMS.

Topics: Adult; Biomarkers, Tumor; Carcinoembryonic Antigen; Diagnosis, Differential; Epidermal Cyst; Humans; Immunohistochemistry; Keratins; Male; Mohs Surgery; Sweat Gland Neoplasms; Syringoma

Panfolliculoma is a rare follicular neoplasm with differentiation toward both upper (infundibulum and isthmus) and lower (stem, hair matrix, and bulb) segments of a hair follicle. We present an unusual case of cystic panfolliculoma. A 33-year-old Hispanic woman presented with an 8-month history of a 3.0-cm cystic scalp mass. The lesion was excised, and the histologic sections showed a cystic follicular neoplasm that contained corneocytes in basket-woven and laminated array, trichohyalin granules of the inner root sheath, germinative cells, papillae, matrical cells, and "shadow" cells. Cytokeratin 903 and cytokeratin 5/6 immunostains uniformly highlight the tumor cells. Ber-EP4 strongly labels the germinative cells but not the follicular papillae. CD34 labels the surrounding fibrotic stroma and focally the epithelial component.

Topics: Adult; Biomarkers, Tumor; Epidermal Cyst; Female; Follicular Cyst; Hair Follicle; Humans; Keratins; Neoplasms, Basal Cell; Skin; Skin Neoplasms

Pachyonychia congenita type 2 (PC-2) is an autosomal dominant disorder characterized by hypertrophic nail dystrophy, focal keratoderma, multiple pilosebaceous cysts, and other features of ectodermal dysplasia. It has been demonstrated that PC-2 is caused by mutations in the keratin 17 and keratin 6b genes. In this report, we describe a missense mutation in the keratin 17 gene, M88T, in a Korean patient whose phenotype included early onset steatocystoma multiplex and Hutchinson-like tooth deformities along with other typical features of PC-2 such as hypertrophic nails, natal teeth and follicular hyperkeratosis.

Topics: Child; Ectodermal Dysplasia; Epidermal Cyst; Humans; Keratins; Male; Mutation; Nails, Malformed; Sebaceous Gland Diseases; Tooth Abnormalities

Topics: Basal Cell Nevus Syndrome; Diagnosis, Differential; Epidermal Cyst; Humans; Keratins; Leg; Male; Middle Aged; Skin Diseases

To investigate the in vitro and in vivo proliferative capacity of human conjunctival epithelial cells cultured in serum-free media, and to compare this with current methods that utilize serum-containing media and 3T3 feeder layers.. Human conjunctival epithelial cells were cultivated in serum-free media alone, serum-free media with a 3T3 feeder layer, and serum-containing media with a 3T3 feeder layer. The areas of outgrowth, colony-forming efficiencies and number of population doublings were compared. The in vivo proliferative potential was assessed by analyzing the number of cells generated by the implantation of cultured cells into athymic mice. Cultured cells were evaluated for the expression of cytokeratins K3, K4, K12, K19, as well as the gel-forming goblet cell mucin, MUC5AC.. Cells cultivated in serum-free media, serum-free media and feeder cells, and serum-containing media and feeder cells achieved colony-forming efficiencies of 14.5 +/- 4.1%, 10.1 +/- 3.1%, and 20.4 +/- 6.7%, respectively, and number of population doublings of 24.8 +/- 4.3, 14.8 +/- 3.6, and 30.0 +/- 5.0, respectively. Nine-day old athymic mice conjunctival cysts derived from serum-free cultures comprised 1.29 x 10(6) +/- 0.46 x 10(6) cells, while cysts derived from serum-containing cultures comprised 1.30 x 10(6) +/- 0.53 x 10(6) cells. The degree of epithelial stratification was similar in both conditions. Serum-free cultivated conjunctival cells retained their in vivo characteristics and expressed K4, K19 and MUC5AC. The presence of MUC5AC mRNA in these cells was confirmed by RT-PCR.. Conjunctival epithelial cells propagated in serum-free media demonstrated a similar in vivo proliferative capability, as compared to serum-containing media with 3T3 feeder cells. This has important clinical implications, as the serum-free ex vivo expansion of cells for clinical transplantation overcomes the problems associated with the use of animal serum and cells.

Topics: 3T3 Cells; Animals; Cell Culture Techniques; Cell Division; Cell Transplantation; Coculture Techniques; Conjunctiva; Culture Media, Serum-Free; Epidermal Cyst; Epithelial Cells; Fluorescent Antibody Technique, Indirect; Humans; Keratins; Mice; Mice, Nude; Mucin 5AC; Mucin-5B; Mucins; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger

A 20-year-old Japanese woman with an epidermal cyst on the back is described. Physical examination revealed a deep blue and round shaped cystic lesion measuring 10 min in diameter. A comedo-like keratotic plug also could be seen at the center. Histologically, the inner surface of the cyst was clearly separated of two types of the cells. The one was layers of epidermal keratinocytes and the other looked like a basal layer of epidermis, which immunohistochemically stained by S-100, HMB-45, cytokeratin (CK19) and Fontana-Masson staining. We diagnosed this case as epidermal cyst with pilomatrical differentiation.

Topics: Adult; Cell Differentiation; Epidermal Cyst; Epidermis; Female; Hair Follicle; Humans; Immunohistochemistry; Keratinocytes; Keratins; S100 Proteins; Silver Nitrate; Skin Diseases; Staining and Labeling; Treatment Outcome

Topics: Back; Connective Tissue Diseases; Epidermal Cyst; Humans; Keratins; Male; Middle Aged

Pachyonychia congenita (PC) is a group of autosomal dominant ectodermal dysplasias caused by mutations in four differentiation-specific keratin genes. Two major clinical subtypes of PC have been generally recognized. Symmetrically thickened fingernails and toenails are the defining characteristic of PC type 2 (PC-2) with onset at infancy. Pilosebaceous cysts are the best hallmark of PC-2, but they usually occur at puberty.. To report a Chinese pedigree of PC-2 with unusually early onset sebaceous cysts and to explore the genetic mutation and its phenotype.. Exon 1 of keratin 17 was amplified by polymerase chain reaction (PCR) from genomic DNA from the three patients in the pedigree, the proband, his half-sister and his younger son, two unaffected members in the pedigree and 50 unrelated and unaffected people. PCR products were directly sequenced to detect the mutation.. Direct sequencing of the PCR products revealed a heterozygous 275A-->G mutation in all three affected members. This mutation predicts the substitution of asparagine by serine in codon 92 (N92S) located in the 1A domain of keratin 17.. Mutation in the 1A domain of keratin 17 underlies the affected members' phenotype, PC-2 with early onset sebaceous cysts and late-onset thickened fingernails and toenails. The onset of the cysts is very early in some people within this family and the age at onset of thickened fingernails and toenails is variable within the family, implying the existence of modifying factors.

Topics: Adolescent; Age of Onset; China; Ectodermal Dysplasia; Epidermal Cyst; Female; Humans; Infant; Keratins; Male; Mutation; Nails, Malformed; Pedigree; Phenotype; Polymerase Chain Reaction; Skin Diseases

To study the incidence, size, and origin of epidermoid formations after accurately characterizing them by cytokeratin immunohistochemical analysis.. A strategy of screening sections for possible epidermoid formations in the entire eardrum area in paraffin-embedded, serially sectioned developing temporal bones was used. Unstained adjacent sections were subjected to immunohistochemical staining, to provide accurately identified epidermoid formations for a study of their appearance and size in relation to age.. The immunohistochemical expression patterns for epidermoid cytokeratins of several antibodies at different gestational ages were determined. Then, epithelial structures suspected as epidermoid formations were characterized as epidermoid with age-appropriate antibodies in 36 paraffin-embedded temporal bones from 19 cases with an age range of 6 gestational weeks to 15 months postpartum using a novel method of antigen retrieval by heating sections in a 70 degrees C water bath.. Each of 22 temporal bones ranging in age from 16 weeks gestation to 8 months postpartum contained one or more, often numerous, epidermoid formations. Sizes of epidermoid formations increased significantly with increasing age. The formations were found anywhere in the annular lateral wall region of middle ear, but the majority were in the anterosuperior region. A further study of the interface between annular external canal epidermis and middle ear epithelium in a larger group suggested that epidermoid formations arise at approximately 16 gestational weeks from the external canal epidermis.. The findings indicate that epidermoid tissue in the middle ear normally originates from external canal epidermis at approximately the 16th gestational week and grows before disappearing.

Topics: Cholesteatoma, Middle Ear; Ear Canal; Epidermal Cyst; Epidermis; Female; Gestational Age; Humans; Immunoenzyme Techniques; Infant; Infant, Newborn; Keratins

We report a 71-year-old Japanese female with a dilated pore in the form of a nodule above her right eyebrow. Histologic examination revealed a flask-shaped, keratinous cystic structure that was continuous with the surface epidermis and had numerous elongated rete ridges in the lower portion. An immunohistochemical study using a panel of monoclonal antibodies against cytokeratins (CKs) and involucrin detected CK1 and CK10 in the suprabasal cells of the cystic structure. CK8 and CK19 expression was observed in the outermost layer of some elongated rete ridges; it was composed of pallisading columnar cells. Most parts of the outermost layer of the cystic structure stained positively with AE1 antibody. From these immunohistochemical findings, we speculated that the dilated pore in our case was an isolated clinical entity is a follicular tumor differentiating mainly toward the infundibulum and partly toward the isthmus.

Topics: Aged; Biopsy, Needle; Epidermal Cyst; Epidermis; Eyebrows; Female; Humans; Immunohistochemistry; Keratins; Sensitivity and Specificity; Skin Diseases

Topics: Diagnosis, Differential; Epidermal Cyst; Humans; Keratins; Leg; Male; Middle Aged

Carcinomas that arise in a proliferating trichilemmal cyst (PTC) have been described under a variety of names. Monoclonal antibodies (mAbs) indicating follicular differentiation have become available and were used here in two rare tumors with uncommon biologic behavior. To further elucidate the histogenesis of carcinomas arising in a PTC, mAbs to hair follicle stem cells and to hair follicle differentiation-specific cytokeratins (mAbs to cytokeratin [CK] 7, CK8, CK18, and CK19 as well as mAbs to CD8/CK15 and CD34) were studied on paraffin-embedded sections of two cases of carcinoma arising in a PTC, one anaplastic carcinoma, and one poorly differentiated squamous cell carcinoma (SCC). For comparison, concurrent PTCs and trichilemmal cysts as well as four SCCs from controls were studied. The anaplastic carcinoma showed expression of CK7, indicating a fetal hair root phenotype, and expression of CD34, indicating trichilemmal differentiation. In contrast, the poorly differentiated SCCs as well as the control SCCs stained negative for most of the mAbs applied. Expression of fetal and trichilemmal hair follicle phenotypes suggests differentiation from hair stem cells and might explain differences in biologic behavior.

Topics: Aged; Biomarkers; Carcinoma, Squamous Cell; Cell Division; Epidermal Cyst; Female; Hair Diseases; Hair Follicle; Humans; Keratins; Phenotype; Scalp; Skin Neoplasms

Topics: Abdominal Muscles; Adolescent; Cilia; Epidermal Cyst; Female; Humans; Immunohistochemistry; Keratins; Skin Diseases; Treatment Outcome

Topics: Adult; Diagnosis, Differential; Epidermal Cyst; Humans; Keratins; Lip Diseases; Male

Topics: Adult; Aged; Biomarkers; Epidermal Cyst; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Sebaceous Glands; Skin Diseases

Topics: Adult; Diagnosis, Differential; Epidermal Cyst; Head and Neck Neoplasms; Humans; Keratins; Magnetic Resonance Imaging; Male; Skin Diseases

To study the relationship between steatocystoma multiplex (SCM) and keratin 17 gene mutation.. The keratin 17 gene mutation in the cDNA of cystic tissue of 5 patients of SCM and in the DNA in peripheral blood of 25 patients with SCM from a SCM family was studied by direct sequencing of the RT-PCR products, nested PCR, and restricted fraction length polymorphism (RFLP) analysis. Thirty-nine blood specimens from the unaffected members of that family were collected and tested too. Ten DNA pool specimens and other 2000 DNA pool specimens of normal individuals outside that SCM family were used as controls.. In the base 428, 94(th) codon in keratin 17 gene in the cDNA of patients' cystic tissue, R94C mutation, a G-->A mutation, was detected Nested PCR, and restricted enzyme Acil polymorphism analysis showed that in the DNA specimens of peripheral blood of patients a mutated allele lacking enzyme cutting locus was detected, thus causing an uncut band with 200 bp while the corresponding allele was cut and caused two bands with 108 bp and 92 bp. In the DNA pool specimens of normal controls only these two bands with 108 bp and 92 bp were observed.. The R94C mutation in keratin 17 gene is one of the genetic bases of SCM in Chinese. The results of this study provide scientific data for genetic diagnosis and counseling of SCM.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Epidermal Cyst; Female; Humans; Keratins; Male; Middle Aged; Point Mutation; Skin Diseases

The use and limitations of fine-needle aspiration (FNA) of lesions of the parotid gland are known, but those of nonparotid lesions of the head have been described only sporadically. We conducted this study to evaluate the utility of FNA and to analyze the causes of diagnostic discrepancies for these lesions. A total of 6,898 FNAs of different sites was performed at our institutions between January 1991-August 1998, and 214 (3.1%) of the cases were FNAs of nonparotid lesions of the head. The most common diagnosis of nonparotid lesions was squamous-cell carcinoma, in 22% (n = 48), and the most common site aspirated was the scalp, in 34% (n = 73). Lipomas and keratinous cysts comprised 5% (n = 9) of the total. A statistical analysis was conducted on 98 paired cytology and histology (n = 83) and cytology and flow cytometry (n = 15) specimens (70 malignant and 28 benign). FNA recognized the malignant and benign nature of the lesion in 60 and 26 cases, respectively with 86% sensitivity 93% specificity and 88% accuracy. Causes of false-negative FNA diagnoses (n = 10) included sampling error (n = 6), bloody smears with scant cellularity (n = 3), and bland cytomorphology (n = 1). Florid granulation tissue and a mucocele of the tongue accounted for the two false-positive cases. We conclude that FNA is an effective tool for triage of surgery candidates with nonparotid lesions of the head. Adequate samples with sufficient cellularity are required for avoiding false-negative diagnoses. Occasionally, tissue biopsy is needed for diagnosis of equivocal cases.

Topics: Adult; Aged; Aged, 80 and over; Biopsy, Needle; Carcinoma, Squamous Cell; Epidermal Cyst; Evaluation Studies as Topic; Female; Head and Neck Neoplasms; Humans; Keratins; Lipoma; Male; Middle Aged; Multiple Myeloma; Scalp; Sensitivity and Specificity

Topics: Aged; Ear Diseases; Ear, External; Epidermal Cyst; Female; Humans; Keratins; Skin Diseases

Topics: Antibodies; Eccrine Glands; Epidermal Cyst; Foot Dermatoses; Humans; Immunohistochemistry; Keratins; Papillomaviridae; Papillomavirus Infections; Tumor Virus Infections

Epidermoid cysts are rare lesions in the head and neck. Most often the are located in the submental region, although they sometimes can impose certain diagnostic problems. We report the case of a 19-year-old girl who presented with a fluctuant, painless, midline swelling of the floor of her mouth that had persisted for three months. Ultrasonographic examination showed a 5 x 5 x 4 cm cystic tumor with the unusual aspect of multiple smaller spherical formations. The differential diagnosis of the lesion included dermoid cysts, epidermoid cysts, ranula and parasitic lesions. Computed tomography and magnetic resonance tomography were not diagnostic. The patient underwent excision of the lesion, during which the cyst was completely removed. Histopathological diagnosis was consistent with an epidermoid cyst. The striking sonographic aspect of multiple spherical formations in the lesion was caused by multiple spherical keratin formations.

Topics: Adult; Diagnosis, Differential; Epidermal Cyst; Female; Humans; Keratins; Mouth Diseases; Mouth Floor; Ultrasonography

Sixteen cases of epidermal cyst (EC) (6 cases of conventional EC and 10 cases of plantar epidermoid cyst (PEC)) and 9 cases of trichilemmal cyst (TC) were examined by an immunohistochemical technique using various antibodies against cytokeratins and human papilloma virus (HPV) in order to clarify their histogenesis. There was no difference in immunoreactivities between EC and PEC with or without HPV infection. In TC, the inner layers of the cyst wall were stained with the antibody E3 (CK17), and the outermost layer was stained with the antibodies 4.1.18 (CK8) and 170.2.14 (CK19). In PEC and EC, however, the cyst wall didn't react with these antibodies, and differentiation-specific cytokeratins were expressed in the inner layer. These results confirmed that the immunoreactivities of PEC and EC were identical to those of normal epidermis or infundibulum, and that those of TC were similar to the outer root sheath between the lower infundibulum and isthmus. Although PEC has been recently reported to originate from eccrine ducts, there was a significant difference in immunoreactivities between PEC and eccrine ducts. Furthermore, on the basis of the fact that sole skin has no hair follicles, PEC was speculated to originate from epidermal implantation.

Topics: Adolescent; Adult; Aged; Epidermal Cyst; Female; Foot Dermatoses; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Papillomaviridae; Skin Diseases

Clarification of the pathogenesis of psoriasis requires separate studies of the epidermis, dermis, and inflammatory cells. We previously subcutaneously transplanted a mixture of cultured human keratinocytes and fibroblasts into mice to develop cysts with human skin structures. Using this method, we separately cultured psoriatic and normal keratinocytes and fibroblasts. Four mixtures were prepared: normal keratinocytes and normal fibroblasts (NK/NF); psoriatic keratinocytes and normal fibroblasts (PK/NF); normal keratinocytes and psoriatic fibroblasts (NK/PF); and psoriatic keratinocytes and psoriatic fibroblasts (PK/PF). Each mixture was transplanted into immunodeficient mice to observe formation of cysts and histological changes. The cysts varied in structure depending on the mixture, which suggests that psoriatic keratinocytes and fibroblasts had some abnormalities. Psoriatic fibroblasts may be partially responsible for thickening of the epidermis. Cell differentiation might have been accelerated in psoriatic keratinocytes after transplantation, resulting in the loss of epidermis structures.

Topics: Animals; Cell Communication; Cell Differentiation; Cell Transplantation; Cells, Cultured; Epidermal Cyst; Fibroblasts; Humans; Immunoenzyme Techniques; Keratinocytes; Keratins; Mice; Mice, Inbred BALB C; Mice, Nude; Mice, SCID; Psoriasis; Severe Combined Immunodeficiency; Skin; Transplantation, Heterologous

We report here two rare cystic lesions, a lymphoepithelial cyst (LEC) and an epidermoid cyst of the accessory spleen (ECAS) occurring in the pancreas. Histologically, the LEC was lined by stratified squamous epithelium and surrounded by a layer of lymphoid tissue with germinal centers. The ECAS showed similar histologic features with scattered lymphoid tissue, but splenic pulp tissue was present in the wall. In both cysts, some small pancreatic islets and ducts were seen in the fibrous tissue surrounding the lymphoid layer or the splenic pulp, respectively. The lining epithelia of the LEC and the ECAS, as well as those of retention cysts of the pancreas and epidermoid cysts of the spleen used for comparison, were similarly positive with AE1/3, CAM5.2, CK7, CK13, and carcinoembryonic antigen. CA19-9 was also detected in the epithelial cells of the LEC, the ECAS, and the retention cyst of the pancreas, but not in those of the splenic epidermoid or branchial cleft cysts used for comparison. These findings indicate that LECs and ECASs might develop from the pancreatic ducts protruding into a lymph node or accessory spleen located in the pancreas, respectively. Some of both cysts might cause elevated levels of serum carcinoembryonic antigen and/or CA19-9 and should be distinguished from malignant cystic tumors.

Topics: Aged; Antibodies, Monoclonal; Carcinoembryonic Antigen; Choristoma; Cysts; Epidermal Cyst; Epithelial Cells; Female; Humans; Immunoenzyme Techniques; Keratins; Lymphoid Tissue; Male; Middle Aged; Pancreas; Splenic Diseases

Milia en plaque is an uncommon skin condition usually seen in adult women, typically in the retroauricular region. We report a new localization in a young child.. A 6-year-old girl with an uneventful history had developed over the last 7 months an erythematous plaque with numerous whitish-yellow microcysts on the left internal canthus. No local or general favoring factor was found. Skin biopsy showed numerous cystic cavities with an epidermal lining containing layers of keratin within a moderately inflammatory infiltration. The lesion resolved after enucleation of the cysts and no recurrence has been observed after 9 months follow-up.. Milia en plaque is a charateristic erythematous lesion covered with cysts. The usual localization is the retroauricular region, but other localizations have been reported, mainly on the head. This is the first report involving the internal canthus and also in such a young child. One case of a 15-year-old boy has been discribed. Milia en plaque is often a primary condition as in our case although local or general factors may rarely be inductive. Our case illustrates the different localizations possible for milia en plaque, with predominance on the head, and the possibility of childhood cases. We prefer the term milia en plaque rather than retroauricular milia en plaque.

Topics: Child; Diagnosis, Differential; Epidermal Cyst; Erythema; Facial Dermatoses; Female; Follow-Up Studies; Humans; Keratins; Skin Diseases

The environmental pollutant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) causes chloracne in humans by mechanisms that are as yet poorly understood. Because TCDD is known to affect keratinocyte differentiation in vitro, we have studied TCDD-dependent morphologic changes and the expression of murine keratin 1 (MK1; differentiation associated) and keratin 17 (MK17; presumably hyperproliferation associated) in HRS/J hr/hr hairless mouse skin. TCDD (0.2 microg in acetone) applied topically to the dorsal skin caused epidermal acanthosis and hyperkeratosis of the dermal cysts as well as an involution of the utricles and the sebaceous glands. By means of in situ hybridization with digoxigenin-labeled riboprobes of sections from untreated and vehicle (control)-treated skin, we localized MK1 mRNA to the epidermal spinous cell compartment. MK17 transcripts were detected only in the derivatives of the hair follicle-utricle epithelium and dermal cysts. No spatial overlap was observed between MK1 and MK17 expression. After TCDD application, MK17 was newly expressed in the upper spinous cell layers of the interfollicular epidermis, although it was suppressed in the involuting utricles. In contrast, MK1 expression in the interfollicular epidermis was not affected by TCDD. Furthermore, MK1 expression was induced in the epithelium of the utricle remnants and in some dermal cysts. These data suggest that increased keratinization of the part of the follicular epithelium corresponding to the dermal cyst epithelium of hairless mice most probably explains the pathogenesis of TCDD-induced chloracne. The results demonstrate, furthermore, that TCDD can differentially affect keratinocyte differentiation in vivo as well as in vitro.

Topics: Animals; Epidermal Cyst; Epidermis; Female; Gene Expression; Hair Follicle; Keratins; Mice; Mice, Hairless; Polychlorinated Dibenzodioxins; RNA, Messenger; Sebaceous Glands; Skin

We compared the patterns of keratin 10 (K10) and keratin 17 (K17) expression in epidermoid cysts, trichilemmal cysts, eruptive vellus hair cysts, and steatocystoma multiplex. Epidermoid cysts expressed K10 and eruptive vellus hair cysts expressed K17, whereas trichilemmal cysts and steatocystoma multiplex showed expression of both K10 and K17. Our findings support the opinion that eruptive vellus hair cysts, which stained negative for K10, and steatocystoma multiplex are distinct entities and not variants of one disorder.

Topics: Cysts; Epidermal Cyst; Hair; Humans; Immunohistochemistry; Keratin-10; Keratins; Skin Diseases

We report the apparent first case of a trichilemmal cyst presenting intraorally. Trichilemmal cysts are cysts of epithelial origin with a distinctive keratinization pattern that simulates that of the human anagen hair follicle between bulge and sebaceous gland and in the sac surrounding catagen hairs. This type of keratinization of outer root sheath epithelium occurs when it is freed from its internal cover of inner root sheath. This particular case showed evidence of mild epithelial proliferation and slight foci of "metaplastic" epidermoid keratinization, possibly related to mild trauma. The rarity of intraoral hairs undoubtedly accounts for the lack of reported cases of trichilemmal cysts in oral or perioral locations.

Topics: Adult; Epidermal Cyst; Hair Diseases; Hair Follicle; Humans; Keratins; Lip Diseases; Male; Sex Ratio

A family with affected members, previously reported to carry an R94H mutation of keratin K17, and characterized by a variable and oligosymptomatic form of pachyonychia congenita of the Jackson-Sertoli type with steatocystoma multiplex, is described in detail.

Topics: Adult; Epidermal Cyst; Female; Humans; Keratins; Keratoderma, Palmoplantar; Male; Middle Aged; Mutation; Nail Diseases; Pedigree; Phenotype; Skin Diseases

We report a case of neuroendocrine (Merkel cell) carcinoma (NC) of the skin, associated with a trichilemmal cyst, showing pagetoid spread into the trichilemmal epithelium. The association of the two lesions may strengthen the hypothesis that NC originates from pluripotent stem cells of adnexal epithelium.

Topics: Aged; Biomarkers, Tumor; Carcinoma, Merkel Cell; Cell Nucleolus; Cell Nucleus; Chromatin; Cytoplasm; Epidermal Cyst; Epithelium; Female; Humans; Keratins; Neoplastic Stem Cells; Neurofilament Proteins; Phosphopyruvate Hydratase; Skin; Skin Diseases; Skin Neoplasms

The characteristic MRI of scalp trichilemmal cysts is reported. The feature of an iso-intense area on T1-weighted images is unique to trichilemmal cysts. MRI is helpful in diagnosing the trichilemmal cyst and useful in distinguishing cystic tumors on the median scalp from a cranial malformation, meningo- or encephalocele.

Topics: Adult; Aged; Diagnosis, Differential; Encephalocele; Epidermal Cyst; Epithelium; Female; Humans; Keratins; Magnetic Resonance Imaging; Meningocele; Scalp Dermatoses; Skull; Tomography, X-Ray Computed

Topics: Aged; Diagnosis, Differential; Epidermal Cyst; Female; Hair; Humans; Keratins; Magnetic Resonance Imaging; Scalp Dermatoses

Five out of 4,172 operated maxillary cysts (3 developed within the maxillary and 2 in the mandible) presented a malignant change of epithelium. In all these 5 cases histology demonstrated a transition from normal to cancerous epithelium. The overall percentage of malignant change was of 0.12%, with 0.077% for non-keratinized epithelium lining odontogenic cysts (3 cases) and 0.65%, that is 8 times higher, for keratinized ones (2 cases). Keratinization of cystic epithelium and chronic inflammatory lesions were the main risk factors.

Topics: Adult; Aged; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Epidermal Cyst; Epithelium; Female; Humans; Keratins; Male; Mandibular Diseases; Mandibular Neoplasms; Maxillary Diseases; Maxillary Neoplasms; Middle Aged; Odontogenic Cysts; Radicular Cyst

A 62-year-old man presented with a nodule 2 cm in diameter on his left cheek, which he had had since childhood. Histological examination showed a circumscribed dermal nodule composed of sebaceous lobules attached to sebaceous ducts and to an infundibular cyst-like structure connected to the epidermis. The wall was lined with squamous epithelium with a stratum granulosum. This structure was reminiscent of a sebaceous follicle. In addition, a melanocytic naevus of the compound type was found. Immunohistological investigations of the tumour with various cytokeratins revealed a pattern of expression characteristic for the mature sebaceous follicle.

Topics: Biomarkers, Tumor; Cheek; Diagnosis, Differential; Epidermal Cyst; Facial Dermatoses; Hamartoma; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Sebaceous Glands; Skin

We report a case of a cutaneous ciliated cyst in the buttock of a 16-year-old girl. We describe the pathological and immunohistochemical data on this very uncommon skin lesion, whose histogenesis remains a matter of controversy.

Topics: Adolescent; Cilia; Epidermal Cyst; Female; Humans; Keratins; Skin Diseases

We report a case of syringoma clinically presenting as milia in the perianal region. Milium-like syringoma is an unusual clinical variant of the tumor, and this is, to our knowledge, the first reported case occurring perianally.

Topics: Adult; Anus Neoplasms; Cytoplasm; Diagnosis, Differential; Epidermal Cyst; Epithelium; Female; Humans; Keratins; Skin Diseases; Sweat Gland Neoplasms; Syringoma

'Milia en plaque' is an unusual skin disease. Up to date only 6 cases have been reported, and all of them were located in the retro-auricular area. We report herein the first case of milia en plaque developed in the supraclavicular area. The absence of a known aetiologic factor in contrast to the previously published cases suggests that the present case belongs to the group of primary milia.

Topics: Adult; Clavicle; Diagnosis, Differential; Epidermal Cyst; Humans; Keratins; Male; Skin Diseases

In organotypic cultures, outer root sheath (ORS) cells of the human hair follicle develop into a stratified epithelium largely reminiscent of the epidermis; this apparently reflects their importance during wound healing. In the present study, ORS cells were grown inside a three-dimensional network of extracellular matrix proteins (Matrigel), together with different mesenchymal cells, in an attempt to mimic their follicular environment. Thus, inside Matrigel, ORS cells formed spheroids differentiating toward the center and showing all the markers of epidermal keratinization. Under identical conditions, normal epidermal keratinocytes developed similar spheroids, but of a significantly smaller size. Human dermal fibroblasts and dermal papilla cells, cocultured in the matrix, had a positive influence on both the proliferation and differentiation within both types of spheroids. Epidermal differentiation markers, such as suprabasal keratins, involucrin, filaggrin, gp80 and pemphigoid antigen, were readily expressed in ORS spheroids, whereas hard (hair) keratins were not detectable by immunostaining. Cells positive for an epithelial membrane antigen, strongly expressed in sebaceous glands, were seen in numerous spheroids. In contrast to organotypic "surface" epithelia, the expression and location of different integrin chains was normalized in ORS spheroids, indicating an enhanced mesenchymal influence in this in vitro system.

Topics: Biomarkers; Cell Differentiation; Cells, Cultured; Collagen; Culture Techniques; Drug Combinations; Epidermal Cells; Epidermal Cyst; Filaggrin Proteins; Fluorescent Antibody Technique; Hair; Humans; Integrins; Keratinocytes; Keratins; Laminin; Mesoderm; Organoids; Proteoglycans

The stratified squamous epithelium of a splenic epidermoid cyst was studied with a battery of monoclonal antibodies to cytokeratin (CK) proteins. CKs 10 and 11 were found in the suprabasal layers of the stratified squamous epithelium, while staining for CK 13 was focal or diffuse throughout. CKs 18 and 19 decorated individual squamous cells or stained the entire thickness of the epithelium. These results were compared with those previously obtained by us in stratified squamous epithelia of ovarian mature cystic teratoma, fetal epidermis, adult epidermis and squamous metaplasia in a peritoneal cyst. From these comparisons it emerges that the epidermoid splenic cyst is either of teratomatous derivation or originates from inclusion of fetal squamous epithelium. Squamous metaplasia of mesothelium or inclusions of mature squamous epithelium appears to be an unlikely source of origin of these cysts.

Topics: Adolescent; Antibodies, Monoclonal; Epidermal Cyst; Epithelium; Female; Humans; Immunoenzyme Techniques; Keratins; Spleen; Splenectomy; Splenic Diseases

To determine the behavior of epidermal cells after transplantation in the middle ear.. In a rat model, full-thickness meatal skin grafts were transplanted into the middle ear and studied morphologically and immunohistochemically with the use of antibodies directed against different cytokeratin (Ck) polypeptides, which are markers of different types of epithelial cell differentiation.. The grafts had either transformed into epithelial cysts or had become integrated into the middle ear epithelium. The epithelium of the integrated grafts showed gradual transition into the epithelium of the middle ear. A clear distinction between epidermal cells and middle ear epithelium could be made only on the basis of their Ck profiles. The Ck profiles of the grafts revealed a decrease in the expression of epidermal Cks, while nonepidermal Cks became expressed. These changes can be ascribed to replacement of the dermal mesenchyma by mesenchyma from the middle ear. In two ears with superimposed infection, the graft epithelium showed expansive growth.. Meatal epidermis is well tolerated in the middle ear, but superimposed infection can induce expansive growth. These findings favor the concept that the progressive growth of cholesteatoma is related to the presence of inflammatory processes.

Topics: Animals; Antibodies, Monoclonal; Bacterial Infections; Cell Differentiation; Connective Tissue; Dendritic Cells; Ear Canal; Ear Diseases; Ear, Middle; Epidermal Cyst; Epidermis; Epithelium; Keratinocytes; Keratins; Mesoderm; Rats; Rats, Wistar; Skin; Skin Transplantation; Vimentin

We describe 13 cases of tricholemmal carcinoma, a rarely recognized cutaneous adnexal neoplasm. The patients were nine men and four women. In general, the tumors presented as slow-growing epidermal papules, indurated plaques, or nodules showing predilection for sun-exposed, hair-bearing skin. The lesions were most frequently misdiagnosed clinically as basal cell carcinoma. Histologically, they showed a variegation of growth patterns including solid, lobular, and trabecular; they were characterized by a proliferation of epithelial cells with features of outer root sheath differentiation, including abundant glycogen-rich, clear cytoplasm, foci of pilar-type keratinization, and peripheral palisading of cells with subnuclear vacuolization. Because of their variable growth pattern, overt cytologic atypia, abundant clear cytoplasm, occasional pagetoid intraepidermal spread, and brisk mitotic activity, these tumors may pose difficulties for diagnosis and be confused with other malignant skin tumors with clear cell changes. Despite the seemingly malignant cytological appearance of these lesions, clinical follow-up in 10 cases showed no recurrence or metastasis over a period of 2-8 years. Thus, conservative surgical excision with clear margins appears to be the treatment of choice for these neoplasms.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Cytoplasm; Diagnosis, Differential; Epidermal Cyst; Epithelium; Female; Follow-Up Studies; Glycogen; Hair Diseases; Humans; Keratins; Male; Middle Aged; Mitosis; Neoplasms, Basal Cell; Skin Diseases; Skin Neoplasms; Vacuoles

Topics: Cysts; Epidermal Cyst; Hair Diseases; Humans; Keratins; Skin Diseases

The etiological theories of vocal fold cysts can be divided into two basic groups: those of congenital and acquired cysts. In ongoing practice, the authors had noted that the greater number of cysts appeared at the functionally most active segment of the vocal folds which, on the other hand, has the least number of glands. Also, it had been noted that patients with vocal fold cysts tended to have hyperkinetic patterns of voice production. These observations indicated the possibility of a functional aspect in the etiology of vocal fold cysts, and consideration of such a possibility was the aim of this work. In 37 cases, the exact location of the cyst was established. In addition, the muscular activity of the phonatory apparatus was estimated, patient self-descriptions with respect to talkativeness were taken into account, and histological evaluations were made. The cysts were most frequently found in the area of the junction of the anterior and middle thirds of the free edge of the vocal fold. Muscular activity during speech and phonation was increased in study patients. Sixty-five percent of patients had epidermoid cysts and 35% had retention cysts of the vocal fold. According to study results, the functional aspect of cyst genesis has a marked role in the etiology of vocal fold cysts, which points to the great importance of functional care for cyst patients.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cholesterol; Electromyography; Epidermal Cyst; Epithelium; Female; Humans; Keratins; Laryngeal Diseases; Laryngoscopy; Male; Middle Aged; Mucocele; Mucus; Phonation; Speech; Vocal Cords

The types of orbital cysts that are most familiar to ophthalmologists are epidermoid and dermoid cysts, both of which are lined by keratinized stratified squamous epithelium. We studied six patients who had orbital cysts lined by nonkeratinized epithelium that resembled normal conjunctiva. Compared with epidermoid and dermoid cysts, these primary nonkeratinized cysts tend to cause symptoms later in life, occur preferentially in the superonasal aspect of the orbit, and are less likely to be associated with underlying bony changes.

Topics: Adult; Child, Preschool; Conjunctiva; Epidermal Cyst; Epithelium; Female; Humans; Keratins; Male; Middle Aged; Orbital Diseases; Tomography, X-Ray Computed

The appearance of calcific masses within the dermis of scrotal skin is generally referred to as idiopathic scrotal calcinosis. There has been some debate about the pathogenesis of these calcium deposits. This debate centers on the question of whether the calcium deposition is truly idiopathic or whether it occurs as a result of preexisting epidermal cysts. We have performed immunohistochemical staining for keratin in nine patients with apparent idiopathic scrotal calcinosis and have found no evidence of keratin in the dermal tissue immediately adjacent to the calcium deposits. We conclude that idiopathic scrotal calcinosis is idiopathic.

Topics: Adolescent; Adult; Aged; Calcinosis; Epidermal Cyst; Genital Diseases, Male; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Scrotum; Skin Diseases

We report a 58-year-old woman with proliferating trichilemmal cyst (PTC), from which a spindle cell carcinoma arose. The tumor on her scalp had been removed at another hospital. Histological examination had revealed almost typical features of PTC. However, the case showed a partial transformation to spindle cell carcinoma, and transition zones between squamous epithelium and spindle cells were present. Three months after histologic examination, the patient came to us for the treatment of recurrent tumor. Despite surgical resection, the patient died as a result of distant metastases. Histologically, the recurrent tumor was composed of only spindle-shaped tumor cells. We describe the first example of this uncommon condition.

Topics: Carcinoma; Diagnosis, Differential; Epidermal Cyst; Female; Humans; Immunohistochemistry; Keratins; Lung Neoplasms; Middle Aged; Skin Diseases; Skin Neoplasms

The differentiation state of skin epithelial cysts and some uncommon types of epithelial skin tumours was investigated by immunohistochemical staining, mainly using cytokeratin (CK) polypeptide-specific monoclonal antibodies. Samples of interfollicular epidermis, hair follicles and eccrine sweat glands were included as reference tissues. The CK reactivity in epidermoid cysts and milia is not restricted to CKs involved in epidermal-type differentiation, i.e. CK1, 5, 10 and 14, but in addition CK16, a hyperproliferative keratinocyte marker is suprabasally expressed. CK1 and 10 are other prominent suprabasal markers, while CK14 seems to be preferentially expressed in the basal cell layer. Of the non-epidermal CKs, only CK4 was focally or more extensively detected in about 50% of the cases. In terms of CK reactivity, keratinization of trichilemmal cysts corresponds to the keratinization of the anagen-phase hair follicle in the isthmus. The CK reactivity is again restricted to CK1, 5, 10, 14 and 16. However, the CK1 as well as CK10 reactivity is subject to serious limitations, since both CKs were only convincingly observed in foci of terminal differentiation. Eccrine hydrocystoma obligatorily expresses a complex CK set, including CK7, 8, 14, 18 and 19. This CK set perfectly corresponds to the CK composition observed in acini of eccrine sweat glands. In addition, a discontinuous CK4 and 16 reactivity was seen in about 50% of the sites, while CK1 and 10 displayed a strictly focal appearance. On the other hand, syringoma produces in its distinct structures, a CK pattern reminiscent of the one observed in eccrine sweat gland ducts and includes CK1, 5, 10, 14, 16 and 19.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Antibodies, Monoclonal; Antibody Specificity; Cysts; Epidermal Cyst; Epithelium; Gene Expression; Humans; Immunohistochemistry; Keratins; Peptides; Skin; Skin Diseases; Skin Neoplasms

The patterns of cytokeratin expression in the epithelium of 5 dental follicles, 7 dentigerous cysts, 5 odontogenic keratocysts, 3 nasopalatine cysts and an epidermoid cyst have been studies using a panel of monoclonal antibodies. The epithelium of dental follicles and of developmental odontogenic cysts strongly expressed keratins 5 and 19 and showed weaker expression of keratins typical of stratified non-cornified and of simple epithelia. Staining with mAbs against the latter keratins varied with the degree of epithelial differentiation. Nasopalatine cysts strongly expressed simple epithelial keratins and the epidermoid cyst strongly expressed a marker of cornification. Odontogenic cysts thus appear to differ in their pattern of keratin expression from other oral developmental cysts and all derivatives of odontogenic epithelia appear to share similar basic patterns of cytokeratin expression.

Topics: Antibodies, Monoclonal; Dental Sac; Dentigerous Cyst; Epidermal Cyst; Epithelium; Fluorescent Antibody Technique; Humans; Immunoenzyme Techniques; Keratins; Nonodontogenic Cysts; Odontogenic Cysts; Tooth Germ

This report details an additional case of the very rare instance of a respiratory epithelium-lined intracerebral cyst without communication with the ventricular system. Immunohistologic analysis supports an epithelial rather than neuroectodermal origin. Management using endoneurosurgical techniques is described.

Topics: Adult; Brain Diseases; Endoscopy; Epidermal Cyst; Humans; Immunohistochemistry; Keratins; Male

A 29-year-old man had a 2-year history of multiple, asymptomatic, firm, subcutaneous nodules on the scrotal skin, which sometimes discharged a chalky material. Fifty-one nodules were observed in the histopathologic examination, which revealed, in addition to the typical findings of idiopathic calcinosis of the scrotum, various forms of intact cysts: epidermal (some calcified), pilar (calcified), hybrid (calcified), and indeterminate cysts with diffusely calcified keratinous content and attenuated walls. A mixture of calcified keratinous material and inflammatory infiltrates was detected, with or without remnants of the cyst wall. These findings suggest that idiopathic calcinosis of the scrotum derives from the dystrophic calcification of cysts.

Topics: Adult; Calcinosis; Epidermal Cyst; Genital Diseases, Male; Humans; Keratins; Male; Scrotum

Microscopic examination of a cystic epithelial tumor removed from the elbow of a 52-year-old man showed islands of epithelium undergoing keratinization without formation of a visible granular cell layer, as occurs within the follicular isthmus, in trichilemmal cysts, and in pilar tumors (proliferating trichilemmal cysts). Other areas showed keratinization with the formation of a distinct, even prominent, granular cell layer, as seen within the follicular infundibulum and in epidermal cysts. Possible modes of origin and relationships among these tumors and epidermal cysts are presented.

Topics: Epidermal Cyst; Hair; Humans; Keratins; Male; Middle Aged; Skin Diseases

Epidermal and pilar cysts have been stained with anti-keratin antibodies raised from human hair and human callus. The staining properties of the two cysts are different and, in general, support the idea that they originate from epidermis and trichilemmal hair follicle layer respectively.

Topics: Epidermal Cyst; Humans; Immunoenzyme Techniques; Keratins

Topics: Epidermal Cyst; Female; Fluorescent Antibody Technique; Hair Diseases; Humans; Keratins; Middle Aged; Scalp Dermatoses

Topics: Electrophoresis, Polyacrylamide Gel; Epidermal Cyst; Female; Humans; Immunodiffusion; Keratins; Middle Aged; Scalp Dermatoses

Topics: Cell Nucleus; Cytoskeleton; Desmosomes; Epidermal Cyst; Female; Humans; Keratins; Middle Aged

An attic cholesteatoma is defined as an epidermoid cyst found in the attic. This is differentiated from an infected retraction pocket of the pars tensa or a retraction pocket cholesteatoma. Stratified squamous epithelium may also be present in the middle ear as other clinical or pathological entities, such as metaplastic islands of the mucosa in chronic ears with central perforations. Histological examination of 22 temporal bones with attic cholesteatomas has shown them to reside mainly medial to the ossicular chain. This explains the difficulty they have in self-cleansing, as well as the ensuing secondary infection. When a similar process occurs lateral to the ossicles, a self-cleansing nature's atticotomy may be formed. The aetiology of an attic epidermoid cyst, i.e., an attic cholesteatoma, is usually considered to be an invasive retraction from the external ear. However, it is difficult to accept invasion of external canal skin into the upper medial attic. This is especially so in the face of such biological phenomena as epithelial contact inhibition, or the invariable outward migration of stratified squamous epithelium from the edges of retraction pockets as well as from cholesteatoma perforations. Also, large cholesteatomas usually present themselves from the "beginning" simultaneously with their perforations; no documentation of an evolving process from a pre-existing perforation exists at present. Marginal perforations, which have later evolved into attic cholesteatomas have so far not been documented. On the other hand, retraction pockets of the pars tensa or pars flaccida associated with some middle ear negative pressure do occur, however, it is yet to be shown that such retractions can reach the medial part of the ossicular chain and form epidermoid-like cysts there. Therefore, the possibility that an attic cholesteatoma often arises primarily in the attic and presents itself secondarily in the external canal as a "perforated" epidermoid cyst, is to be considered. The possibility that a congenital rest is responsible for such an epidermoid cyst has often been put forward, but evidence that such rests actually exist has not yet been presented. The frequency with which cholesteatoma sacs found in the attic show mucosal cells as part of their lining, suggests a metaplastic phenomenon. This means that the epithelial cells of the middle ear lining may have changed from mucosal into keratinizing cells (or even vice versa). Metaplastic changes of muco

Topics: Cholesteatoma; Ear Diseases; Epidermal Cyst; Epithelium; Eustachian Tube; Humans; Keratins; Metaplasia; Mucus; Temporal Bone; Tympanic Membrane

Recently experienced cases of trichilemmal cysts were studied by light and electron microscopy. Although ultrastructural findings in the present case were basically consistent with those reported in the literature, they were in contrast to them in some important respects: (1) a few, oval and small-sized keratohyalin and a large number of membrane-coating granules were observed in the cytoplasm of keratinizing cells beneath the keratinized cells and (2) the junctional structure between the keratinized cells and the keratinizing cells beneath them showed interdigitation. From these findings, it is shown that trichilemmal cysts have close similarities to and might be derived from the trichilemmal sac surrounding the lower end of the catagen or telogen hair.

Topics: Cell Membrane; Cytoplasm; Cytoplasmic Granules; Epidermal Cyst; Epithelium; Humans; Keratins; Male; Microscopy, Electron; Middle Aged; Skin

Five cases of epidermoid cysts of the ovary are added to the two-reported in the literature. This rare lesion was uniformly an incidental finding in the study of hysterectomy specimens. Its main interest is in its histogenesis, which is suggested to involve metaplasia of the coelomic surface epithelium of the ovary. Ultrastructural evidence is one case strongly favors this possibility, thus adding another line of differentiation to those already established for the multipotent coelomic epithelium. However, some cases may be teratoid in origin, as has been suggested for the analogous lesion in the testis.

Topics: Adult; Epidermal Cyst; Female; Humans; Keratins; Middle Aged; Ovarian Cysts; Ovary

The report deals with a case of epidermoid carcinoma of the vallecula with widespread sebaceous differentiaton. The sebaceous areas were first observed in a cervical lymph-node metastasis, which preceded the discovery of the primary lesion. No similar lesion has been described. Recent literature dealing with extracutaneous sebaceous lesions is cited.

Topics: Aged; Carcinoma, Squamous Cell; Epidermal Cyst; Epiglottis; Humans; Keratins; Laryngeal Neoplasms; Laryngectomy; Male; Neck Dissection; Neoplasm Metastasis

Pathologic changes of free sebaceous glands are rare compared to those of the skin. Two keratin-filled pseudocysts which developed in the excretory ducts of sebaceous glands in the vermilion border of the lower lip in an 86-year-old woman are described. The entity is probably related to milia of the skin.

Topics: Aged; Epidermal Cyst; Female; Humans; Keratins; Lip Diseases; Mouth Mucosa; Sebaceous Glands

Topics: Cytoplasm; Desmosomes; Epidermal Cyst; Epithelial Cells; Epithelium; Humans; Inclusion Bodies; Keratins; Lipid Metabolism; Microscopy, Electron; Sebaceous Glands

Topics: Epidermal Cyst; Hemochromatosis; Humans; Inclusion Bodies; Keratins; Male; Melanins; Microscopy, Electron; Middle Aged; Pigmentation Disorders; Skin; Skin Manifestations

Topics: Adult; Bone Cysts; Carcinoma, Basal Cell; Diagnosis, Differential; Epidermal Cyst; Humans; Jaw Diseases; Keratins; Male; Ribs; Skin; Skin Neoplasms; Syndrome

Topics: Epidermal Cyst; Hair; Histocytochemistry; Humans; Keratins; Male; Prostate; Silicones; Skin; Staining and Labeling; Thyroid Gland

Topics: Cysts; Diagnosis, Differential; Epidermal Cyst; Hair; Humans; Keratins; Skin; Staining and Labeling

Topics: Adult; Cysts; Epidermal Cyst; Humans; Keratins; Long-Term Care; Male; Spinal Cord Diseases

Topics: Cysts; Epidermal Cyst; Humans; Keratins; Scalp; Skin Diseases

Topics: Adenoma; Breast; Breast Neoplasms; Epidermal Cyst; Humans; Keratins; Medical Records; Metaplasia