March 2017 | Case of the Month

History

A 22 year-old man presented with a history of multiple lesions on his trunk that began in adolescence and continued to increased in number. The lesions were asymptomatic. There was no other relevant personal or family history.


Examination

A very large number of small, predominantly blue-grey papules, mainly on the central chest and abdomen.


Investigations

What is the diagnosis?


Images

Diagnosis

RevealHide the answer

The diagnosis is eruptive vellus hair cysts (EVHC)

EVHC is an uncommon condition, characterised by occlusion and cystic dilatation of vellus hair follicles.

The cause is unknown, and cases can be sporadic or familial.

EVHC is likely to be familial if it arises in early childhood. Sporadic forms may appear at any age, although they show a clear trend towards occurring during the first three decades of life. Boys and girls are equally affected.

EVHC presents as small, red-brown or blue-grey papules, most commonly on the central chest, although other sites can be affected, and occasionally it can be generalised. There may be just a few cysts, or, often, there may have several hundred.

The main differential diagnosis is steatocystoma multiplex, which is characterised by the development of numerous yellow-white sebum-containing dermal cysts on the upper trunk, and other sites rich in sebaceous glands. In some familial cases of EVHC these two conditions can coexist.

Please follow the link for eruptive vellus hair cysts to learn more about this condition.

Latest Cases of the Month

September 2021 - Case of the Month

A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well. 

August 2021 - Case of the Month

A 52 year old man presented with a one year history of skin lesions predominantly on his hands, ears and scalp. He was also complaining of painful swollen fingers associated with morning stiffness. There was no family history of skin or joint problem...

July 2021 - Case of the Month

A 72 year old man was referred with a rash, predominantly on the legs. The patient was systemically well and the lesions were only mildly symptomatic. The lesions presented as one to several at a time lasting several weeks. They had not res...

June 2021 - Case of the Month

Welcome back to the new look PCDS website, and our first case. This lady was referred as a 2-week wait with a changing lesion on the right temple.

September 2020 - Case of the Month

A 15 year old lady was referred for a diagnostic opinion for skin changes presenting in birth, affecting the right upper back, shoulder, antecubital fossa and dorsal wrist. The patient was asymptomatic and otherwise well.

The following pharmaceutical companies have had no involvement in the content of this website or in our conference programmes

Almirall
Galderma
Glenmark
Johnson & Johnson
La Roche-Posay
LEO Pharma
Pierre Fabre
Schuco