Dermal cysts

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

Cysts

Common types:[1]

Epidermal necrosis

Venous lake

  • Dilated vein.

Microscopic

Features:[2]

  • Lined by endothelium.
  • Blood in lumen.
  • +/-Fibrin in lumen.

DDx:

  • Angiokeratoma.
    • Ectatic superficial dermal vessels.
    • Irregular acanthosis.
    • Longer rete ridges.

Collagenous fibroma

General

  • Benign.
  • Used to be known as desmoplastic fibroblastoma.

Epidemiology:

  • May be on the lip.

Microscopic

Features:[3][4]

  • Acellular stroma with abundant collagen.

Notes:

  • No nuclear atypia.

Dermatomyositis

See: Neuromuscular_pathology#Dermatomyositis.

Gross

  • Have lesions on the knuckle - Gottron's papulle

Microsopic

Features:

  • Lymphocytic interface dermatitis (inflammation at the dermal-epidermal junction).
  • Loss of rete ridges.

Epidermal inclusion cyst

  • AKA epidermal cyst.

General

  • Very common.

Microscopic

Features:

  • Cyst lining has a granular layer - key feature.[5]
  • Trapped collagen bundles at edge of lesion with surrounded by fibroblasts.
  • Keratin.

Image:

DDx:

Pilar cyst

  • AKA trichilemmal cyst.

General

  • Very common.

Microscopic

Features:

  • Keratin.
  • Cyst lining has no granular layer - key feature.
  • Trapped collagen bundles at edge of lesion with surrounded by fibroblasts.

DDx:

See also

References

  1. TN07 D5
  2. Weedon's Skin Pathology. 3rd Ed. P.895.
  3. URL: http://www.dermatologyoutlines.com/dermskintumornonmelanocytic.html#collagenousfibroma. Accessed on: 19 March
  4. Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 161. ISBN 978-0781740517.
  5. URL: http://emedicine.medscape.com/article/1058907-diagnosis. Accessed on: 18 March 2011.