Steatocystoma Multiplex Clinical Presentation

Updated: Mar 12, 2019
  • Author: Carolyn M Ziemer, MD, MPH; Chief Editor: William D James, MD  more...
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Presentation

History

Affected individuals often present with an increasing number of smooth flesh-to-yellow–colored cysts. The cysts are usually nontender and asymptomatic. On occasion, individual lesions may rupture into the dermis, become inflamed, and form sinus tracts with scarring. Secondary bacterial colonization can lead to malodorous discharge.

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Physical Examination

Lesions present as numerous flesh-to-yellow–colored dermal cysts ranging in size from 3 mm to 3 cm. Individual cysts range from elastic to firm and are often freely movable. The lesions lack a central punctum. Cyst contents appear as an odorless creamy or oily fluid. Individual lesions of steatocystoma multiplex may become suppurative, increase in size, and become prone to rupture (termed steatocystoma multiplex suppurativa). [10] In these cases, secondary bacterial colonization often leads to malodorous discharge. Significant scarring with sinus tract formation may occur.

In typical cases of steatocystoma multiplex, cysts are distributed in areas where high numbers of sebaceous glands are found, most commonly the chest, arms, axillae, and neck. Several reports of localized steatocystoma multiplex limited to the scalp, face, retroauricular region, groin, and nasal region have been reported. [11, 12] Acral steatocystoma multiplex, in which involvement of the extremities is more prominent than the trunk, is uncommon and was described by Rollins et al in 2000. [13]

Steatocystoma multiplex on the chest of an adolesc Steatocystoma multiplex on the chest of an adolescent female.
Steatocystoma multiplex with typical-appearing, sm Steatocystoma multiplex with typical-appearing, smooth, yellow and white dermal cysts.

While some authors refer to localized steatocystoma multiplex as a specific condition, it shares pathological and clinical features of typical cases and is thought to represent a variant of the steatocystoma multiplex rather than a separate disease entity. [11] Linear variants have been reported, [8] and, although rare, generalized eruptions may occur.

Under polarized dermoscopy, facial steatocystomas may demonstrate a yellowish glow with a darker rim, overlying a pseudoreticular pigmentary pattern. [14]

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