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Steatocystoma
Steatocystomas occur as single (steatocystoma simplex) or multiple (steatocystoma multiplex) lesions. They tend to be a few millimeters to a centimeter in diameter and appear as cysts within the dermis that drain oily fluid if punctured (Fig. 110.13AโC). Steatocystomas are most numerous on the chest and in the axillae and groin. There are unusual facial and acral variants as well as a rare congenital linear form. Steatocystomas persist indefinitely, and they are usually asymptomatic except for cosmetic concerns.
Steatocystoma multiplex can be inherited as an autosomal dominant condition, and is due to mutations in KRT17. It may occur in association with eruptive vellus hair cysts and pachyonychia congenita, most frequently PC-17 (see Fig. 58.11).
Pathology
Biopsy specimens show a dermal cyst lined by a thin stratified squamous epithelium without a granular layer. The epithelium is surmounted by a thin, irregular, corrugated eosinophilic cuticle (Fig. 110.13D). Small sebaceous lobules are found in or immediately adjacent to the cyst wall. Cysts with the typical corrugated eosinophilic lining of steatocystoma, but with no adjacent sebaceous glands, have been termed cutaneous keratocyst or sebaceous duct cyst. The latter can be seen in patients with the basal cell nevus syndrome.
Treatment
Lesions can be excised or incised with removal of the cyst wall.