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Follicular Cyst
Follicular Cyst of Skin
| What is a Follicular Cyst of Skin and what are the alternate names? | A keratin filled lesion that presents in the head and neck region and arises from one or more portions of the fair follicle. Alternate names are given depending on the portion of the follicle affected: Epidermoid cyst, infundibular cyst, or Pilar cyst. |
| What are the clinical features of follicular cysts of the skin? | Inflammation of a hair follicle causing a cyst to form in the region, the cyst would be a firm, skin colored, sessile nodule which is freely movable. |
| Describe the Epidermoid (infundibular) csyt. | A firm but malleable flesh colored, dome shaped semi-solid nodule, 0.5-5cm in size. it arises from the infundibulum which is the upper portion of a hair follicle and is located in the dermis. It often has a central pore with foul keratinous pus. |
| Describe a Pilar Cyst | A smooth, mobile, dome shaped, flesh colored, malleable, inflamed and tender nodule often found on the scalp. It is filled with keratin similar to hair and nails, runs in the family and is derived from the outer root sheath of the hair follicle. |
| What are the demographics of Follicular Cysts of the skin. | Pilar cysts are 2 times more common in women. Epidermoid cysts are the most common which account for 80% of cysts in head and neck region. Pilar are 10-15% of skin cysts and are more common in scalp area. 30% of cases are solitary and 70% are multiple. |
| How are follicular cysts of the skin diagnosed and what are the differential diagnoses for this condition? | Diagnosis is obtained by biopsy of the lesion. Differential diagnoses include epidermoid cysts, pilar cysts, sebaceous cysts and Milia. Multiple epidermoid cysts are often associated with Gardner's syndrome. |
| What are the microscopic features of follicular cysts of the skin? | The epidermoid cyst has stratified squamous epithelium with a granular layer and concentric layers of lamellated keratin. A pilar cyst shows a transition from stratified squamous epithelium to the lumen filled with compact keratin with no granular layer. |
| What are the treatment options and prognosis of follicular cysts of the skin? | With a definitive diagnosis after biopsy, treatment is surgical excision. Prognosis is excellent with no observed occurrences of cancerous transformations. |
Created by:
a.juarez
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