Cutaneous cysts: a clinicopathologic analysis of 2,438 cases

Int J Dermatol. 2020 Apr;59(4):457-462. doi: 10.1111/ijd.14808. Epub 2020 Feb 7.

Abstract

Background: Benign cutaneous lesions, so-called cysts, are frequently seen in clinics and might evoke cosmetic and psychosocial concerns.

Aim: This study aimed to demonstrate the clinicopathologic findings of these lesions and also the importance of histological evaluation for prevention of misdiagnosing a benign-appearing malignant lesion.

Methods: A descriptive study was conducted of 2,438 cases who had a diagnosis of cyst confirmed with pathology. The data of patients over the 6-year period between 2011 and 2017, including gender, age, location, prevalence, complications, and microscopic evaluation, were gathered.

Results: From a total of 2,438 records with a clinical diagnosis of mucocutaneous cyst, 2077 had the pathologic diagnosis of cysts. They consisted of 910 women (43.8%) and 1167 men (56.1%) with a mean age of 42. The most common mucocutaneous cysts were epidermal cyst 994 (47.8%) followed by trichilemmal cyst 495 (23.8%). In 479 (19.6%) records, the clinical diagnosis was not congruent with histopathological diagnosis including 45 malignant cases. Basal cell carcinoma in 22 (48.9%) was the most common one.

Conclusions: This study reports on clinical characteristics of cutaneous cysts and the need for a decent diagnostic investigation, like histopathology, for achieving a reliable diagnosis regarding the benign mimicking malignant lesions, especially high risk ones.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carcinoma, Basal Cell / diagnosis*
  • Carcinoma, Basal Cell / epidemiology
  • Carcinoma, Basal Cell / pathology
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Diagnostic Errors / prevention & control
  • Diagnostic Errors / statistics & numerical data
  • Epidermal Cyst / diagnosis*
  • Epidermal Cyst / epidemiology
  • Epidermal Cyst / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Skin / pathology*
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / pathology
  • Young Adult