Eruptive vellus hair cysts
What are eruptive vellus hair cysts?
Eruptive vellus hair cysts are small papules containing vellus hairs. They are usually found on the central chest. Vellus hairs are fine, blond hairs normally growing on face, trunk and limbs (in contrast to terminal hairs, which are longer, pigmented, and mainly arising on scalp, beard, underarms and pubic area). Eruptive vellus hair cysts are quite rare.
What do eruptive vellus hair cysts look like?
Vellus hair cysts usually present as small red or brown bumps over the sternum. They have also been reported to occur on the limbs. There may be few to numerous cysts, sometimes numbering in the hundreds.
Individual lesions are usually small smooth dome-shaped papules, 2-3mm in size. They may be dimpled or umbilicated and sometimes have a scaly or crusty surface.
Who gets eruptive vellus hair cysts?
Eruptive vellus hair cysts are likely to be familial, when they occur in early childhood. Sporadic forms tend to develop later in teenage years. Boys and girls are equally affected.
They are usually an isolated finding and not associated with other skin abnormalities. Eruptive vellus hair cysts sometimes arise in children with anhidrotic and hidrotic ectodermal dysplasia or pachyonychia congenita.
What causes eruptive vellus hair cysts?
Eruptive vellus hair cysts are thought to be the result of occlusion (blockage) at the level of the infundibulum (the part of the hair follicle just below the epidermis), subsequent cystic dilatation (enlargement) of hair follicle and secondary atrophy (withering) of the hair bulb. This is probably a developmental abnormality.
What other conditions should be considered?
Infundibular cysts and steatocystoma multiplex also present as asymptomatic papules or nodules on the anterior chest.
How is the diagnosis made?
The diagnosis of eruptive vellus hair cysts is often made clinically, because of typical age of onset, the site of the lesions, and their appearance.
A punch biopsy is used to confirm the diagnosis. Alternatively, incision or puncture of the cyst and examination of the contents under a microscope will reveal the vellus hairs.
What treatments are available?
In many cases, treatment is unnecessary as the lesions are harmless. The cysts disappear by themselves in about twenty five per cent of children.
- Weedon, D. 2008. Weedon's Skin Pathology. 2nd Edition. Elsevier.p429
- Bolognia JL, Jorizzo JL, Rapani RP. Dermatology: second edition. 2008: 1684-5
- Eruptive Vellus Hair Cysts. – Cory A Dunnick, MD; Chief Editor: Dirk M Elston, MD. Medscape Reference
On DermNet NZ:
- Torchia D, Vega J, Schachner LA. Eruptive Vellus Hair Cysts: A Systematic Review. American Journal of Clinical Dermatology 2012; 13:19-28. doi: 10.2165/11589050-000000000-00000
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