Anhidrotic ectodermal dysplasia with eruptive vellus hair cysts

Abstract

A 21‐year‐old white man complained of heat intolerance, absence of sweating, and papular lesions on the forehead. Facial features included a saddle nose, prominent supraorbital edge, and frontal bossing. The scalp hair was scanty, fine, and brittle. Eyelashes and eyebrows were also thin. Subungual hyperkeratosis and dystrophic changes were observed on the finger and toe nails. Hypodontic teeth were detected on oral examination. He was otherwise healthy. Biochemical and hematologic analyses were also normal. Cutaneous examination revealed smooth and dry skin. Multiple, 4–5 mm, brown–black, comedo‐like, soft papules were observed on the forehead (Fig. 1). A biopsy specimen from a papule on the forehead revealed cystic structures lined by squamous epithelium and containing laminated keratinous material and scattered obliquely and transversely cut vellus hairs (Fig. 2). Topical application of 0.1% tretinoin for 2 months produced no clinical improvement. 1 Scanty and fine scalp hair, prominent supraorbital edge and frontal bossing on the face, and brown–black comedo‐like soft papules (arrows) on the forehead 2 Luminal vellus hairs and laminated keratinous material (hematoxylin and eosin, × 200)

Eruptive Vellus Hair Cysts

“…The authors have no conflicts of interest that are directly relevant to the content of this review. [7,20,23,34,36,43,61,62,111,117,118,146] 1 [110] Surgical excision incision 7 [45,69,106,147,151,152] Carbon dioxide laser 4 [22,74,81] Erbium:YAG laser 5 [55,70,124] 1 [69] Needle evacuation 3 [54,127] Dermabrasion 2 [5,106] 10% urea 2 [5,111] Tazarotene 1 [72] Calcipotriene (calcipotriol) 1 [83] Radiosurgery 1 [119] 12% lactic acid 1 [25] 1 Adapalene 1 [63] 1…”

Eruptive vellus hair cysts: an effective extraction technique for treatment and diagnosis

“…Peeling with keratolytic agents was not felt to be of benefit 1 . Systemic etretinate treatment did not cause improvement in eruptive vellus hair cysts 4,20 . Several mechanical treatment options have been described for these lesions including curettage and cauterization, erbium:YAG laser and carbon dioxide laser vaporization 8,11,12 .…”

“…The disease mostly affects children or young adults and is characterized by asymptomatic, soft, skin‐coloured, comedo‐like papules. The cysts occur predominantly over the anterior part of the chest, extremities and axillae although they can also be seen on the face, neck and groin and may range from a single lesion to hundreds 4–6 . They usually develop slowly, in contrast to their name 2 .…”

Eruptive Vellus Hair Cyst in Patients with Chronic Renal Failure

“…The histological features are distinct and can be differentiated from epidermal cysts, steatocystoma multiplex, milia, dermoid cysts and pilar cysts [1, 2, 3]. The exact etiology is unclear; some lesions show dominant inheritance [4], while others have congenital characteristics [5]and are associated with congenital pachyonychia [6, 7]or ectodermal dysplasia [8, 9]. Eruptive vellus hair cysts may be caused by a developmental abnormality of vellus hair follicles, predisposing them to occlusion at their infundibular level [1, 2, 3].…”