Two Pilosebaceous Cysts with Apocrine Hidrocystoma in One Biopsy Site: CASE REPORT
A 28-year-old woman was evaluated for a 6-year history of multiple, asymptomatic papules located on the chest. Clinical examination revealed smooth surfaced, slightly erythematous, bluish papules on the chest (Fig. 1). The patient had noted gradual progression of the lesions over time on the same area. She had no notable past or family history. The histological examination revealed three round, well defined cystic structures on the upper and lower dermis (Fig. 2A). The first cystic lesion was composed of several squamous and granular layers. The cyst was filled with horny material arranged in laminated layers. These findings were consistent with milia (Fig. 2B).
Fig. 1. Smooth surfaced, slightly erythematous, bluish papules on the chest; inset: close up view of the papule.
The second cyst was lined columnar epithelium and characteristically showed decapitation of cytoplasm of the luminal border, typical of apocrine secretory activity (Fig. 2C). The lower largest cyst was lined stratified squamous cell epithelium and the lumen contained vellus hair shaft, which indicated EVHC (Fig. 2D).
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Fig. 2. (A) Histologic examination of the lesion showed round, well defined multiple cystic structures on the upper and lower dermis (H&E, x 12.5). (B) The upper cyst is composed of several layers of squamous and granular layer and filled with horny material arranged in laminated layers (H&E, x 200). (C) The cyst wall is lined by secretory cells showing decapitation secretion (H&E, x 200). (D) The cyst wall is lined by stratified squamous cell epithelium and the lumen contains vellus hair shaft (H&E, x 200).
