Ömer Faruk ELMAS

Dermoscopic diagnosis of epidermal cyst

Aim: The clinical features of epidermal cyst (EC) are well known, however, dermoscopic aspect of the entity has rarely been a subjectof investigation. Here we aimed to identify the dermoscopic findings of EC which may increase the accuracy of diagnosis beforesurgical interventions.Material and Methods: The study included the patients diagnosed with EC those who applied to outpatient dermatology clinicof a tertiary center. Age and gender of the patients, disease durations, symptoms, site and size of the lesions, dermoscopic andhistopathological findings were retrospectively reviewed.Results: A total of 24 lesions from 24 patients were enrolled in the study. The most common dermoscopic finding was whitestructureless background (96%) followed by punctum/pore sign (75%), widely distributed/branched irregular linear vessels (71%),blue-white structureless color (46%), mobility sign (41%), peripheral thick branched vessel (33%) and polychromatic structures (4%).Conclusion: We describe two novel dermoscopic features which were not described previously for EC: Mobility sign and polychromaticstructures. Along with the previous studies, our study revealed that EC has a peculiar dermoscopic pattern. Dermoscopic examinationmay increase diagnostic accuracy before surgery making possible a management with minimal invasive procedures.

PDF

___

1. Handa U, Kumar S, Mohan H. Aspiration cytology of epidermoid cyst of terminal phalanx Diagn Cytopathol 2002;26:266-7.
2. Elmas OF. Blue-White Variant of Basal Cell Carcinoma As a mimicker of melanoma: dermoscopic analysis. Selcuk Med J 2019;35:85-9.
3. Suh KS, Kang DY, Park JB, et al. Usefulness of Dermoscopy in the differential diagnosis of ruptured and unruptured epidermal cysts. Ann Dermatol 2017;29:33–8.
4. Egawa K, Egawa N, Honda Y. Human papillomavirusassociated plantar epidermoid cyst related to epidermoid metaplasia of the eccrine duct epithelium: a combined histological, immunohistochemical, DNA-DNA in situ hybridization and three-dimensional reconstruction analysis. Br J Dermatol 2005;152:961-7.
5. Lacarrubba F, Verzì AE, Tedeschi A, et al. An Unusual 2-tone epidermal cyst: dermoscopy, confocal microscopy, and histopathologic correlations. JAMA Dermatol 2015;151:1386-8.
6. Krtanjek J, Ilic I, Kendel M, et al. Epidermal Cyst on the face of a child, clinically and dermoscopically mimicking pilomatricoma. Dermatol Pract Concept 2019;9:36-7.
7. Mun JH, Park SM, Kim TW, et al. Importance of keen observation for the diagnosis of epidermal cysts: dermoscopy can be a useful adjuvant tool. J Am Acad Dermatol 2014;71:138-40.
8. Ghigliotti G, Cinotti E, Parodi A. Usefulness of dermoscopy for the diagnosis of epidermal cyst: the ‘pore’ sign. Clin Exp Dermatol 2014;39:649-50.
9. Kelati A, Mernissi FZ. The rainbow pattern in dermoscopy: A zoom on nonkaposi sarcoma skin diseases. Biomed J 2018;41:209-10.
10. Cheng ST1, Ke CL, Lee CH, et al. Rainbow pattern in Kaposi’s sarcoma under polarized dermoscopy: a dermoscopic pathological study. Br J Dermatol 2009;160:801-9.
11. Uzunçakmak TK, Ozkanli S, Karadağ AS. Dermoscopic rainbow pattern in blue nevus. Dermatol Pract Concept 2017;7:60-2.
12. Elmas OF, Akdeniz N. Dermoscopic aspect of verrucous epidermal nevi: New findings. Turk J Med Sci 2019;49.