The Black Keratinous Cyst

Pigmented Epidermal Cyst

“…Usually, two or three layers of the keratinocytes contain melanin granules, as does the normal epidermis (2), so the clinical appearance of the cyst ranges from normal skin color to blue-gray. Leyden et al (5) reported three pigmented epidermal cysts in a black patient with hemochromatosis and concluded that darkening in color of epidermal cysts may indicate the onset of hemochromatosis. Fieselman et al (4), however, disputed the relationship between pigmentation of the epidermal cysts and hemochromatosis, because 97% of epidermal cysts they studied were in blacks, and 37% of them were heavily pigmented; they concluded that the pigmented epidermal cyst is a normal variant in blacks.…”

Pigmented Epidermal Cyst

“…Pigmentation In the lining of an epidermal eyst has been reported in a patient with hemoehromatosis (Leyden et al 1972). It was proposed that the presence of melanin pigment in the lining of the cyst might be an aid in the diagnosis of hemoehromatosis.…”

“…Lever (1967), Allen (1967), Montgomery (1967) and Pinkus & Mehregan (1969) do not mention it in their textbooks on dermatopathology. Graham et al (1972) do note that melanin granules may be seen in epidermal cysts in Negroes, but except for a comment by MeGavran & Binnington (1966) and a report of a case of a pigmented cyst occurring in a man with hemoehromatosis (Leyden et al 1972), this variant has been largely ignored.…”