Histologic Findings

Dermoid cysts are a result of the sequestration of the skin along the lines of embryonic closure. If connected with the ovary, dermoid cysts are true teratomas. Scalp cysts may be evaluated using fine-needle aspiration cytology.^[45]

In contrast to epidermal inclusion cysts, dermoid cysts in the skin are lined by an epidermis that possesses various epidermal appendages. As a rule, these appendages are fully mature. Hair follicles containing hairs that project into the lumen of the cyst are often present. The dermis of dermoid cysts usually contains sebaceous glands, eccrine glands, and, in many patients, apocrine glands. Occasionally, the lining epithelium may proliferate as papillary boundaries extend externally or inward toward the lumen of the cyst. This proliferation may have some superficial resemblance to epidermal carcinomatous proliferation, and the growth may be misclassified as a cancer.

Dermoid cysts in the ovary (cystic teratomas) or those disseminated intra-abdominally may contain other structures such as nails, hairs, or cartilage and bone fragments. These cysts have cell walls that are almost identical to those of the skin, and they may contain multiple adnexal skin structures such as hair follicles, sweat glands, and occasionally, hair, teeth, or nerves.

A congenital dermoid together with a bronchogenic cyst of the tongue is extremely rare but has been described in a few patients.^[46]

Treatment & Management

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Media Gallery

Dermoid cyst in an unusual location. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/lesions/d-cyst.jpg).

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Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Coauthor(s)

Zbigniew Ruszczak, MD, PhD Consultant Dermatologist and Allergist, Department of Medicine, Division of Dermatology, Sheikh Khalifa Medical City, Abu Dhabi, UAE; Consultant in Pediatric Dermatology, Wound Healing and On-Site-Drug Delivery Systems; Visiting Consultant in Dermatology and Dermatopathology, UMDNJ-New Jersey Medical School, Newark

Zbigniew Ruszczak, MD, PhD is a member of the following medical societies: American Academy of Dermatology, New York Academy of Sciences, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Albert C Yan, MD Section Chief, Associate Professor, Department of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine

Albert C Yan, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology, Society for Pediatric Dermatology, American Academy of Pediatrics

Disclosure: Nothing to disclose.

Dermoid Cyst Workup

Histologic Findings

References

Tables

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