RESUMO
A 32-year-old male patient presented for 8 months an asymptomatic therapy-resistant acneiform eruption on his back and buttocks. Skin examination showed several inflammatory papules, which evolved to hyperpigmentation. At the same distribution non inflammatory papules, which resembled rice grains, were also observed. Light microscopy showed small keratin-filled cysts, with an epithelial multilayered wall, without granular layer. Keratin and some vellus hairs were identified inside the cyst, confirming the diagnosis of vellus hair cysts. Diagnosis of vellus hair cysts should be suspected in cases of multiple papules or therapy-resistant cases of acneiform eruptions.
Assuntos
Erupções Acneiformes/patologia , Cisto Epidérmico/patologia , Doenças do Cabelo/patologia , Adulto , Nádegas , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
A 32-year-old male patient presented for 8 months an asymptomatic therapy-resistant acneiform eruption on his back and buttocks. Skin examination showed several inflammatory papules, which evolved to hyperpigmentation. At the same distribution non inflammatory papules, which resembled rice grains, were also observed. Light microscopy showed small keratin-filled cysts, with an epithelial multilayered wall, without granular layer. Keratin and some vellus hairs were identified inside the cyst, confirming the diagnosis of vellus hair cysts. Diagnosis of vellus hair cysts should be suspected in cases of multiple papules or therapy-resistant cases of acneiform eruptions.
Um paciente de 32 anos apresentou há 8 meses uma erupção acneiforme resistente à terapêutica, localizada no dorso e nádegas. Ao exame apresentava inúmeras pápulas inflamatórias, que evoluiam para hiperpigmentação. Na mesma distribuição havia lesões não inflamatórias, lembrando grão de arroz. A microscopia óptica demonstrou cisto dérmico cuja parede era de epitélio estratificado, sem camada granular, preenchido de queratina e com pelos no interior, confirmando o diagnóstico de cisto de pelo veloso. Essa entidade deve ser suspeitada em casos de múltiplas pápulas ou erupções acneiformes resistentes à terapia.
