Multiple Pigmented Follicular Cyst: A Rare Case Report

Background: Pigmented follicular cyst is a rare form of epidermal cyst that usually appears as an asymptomatic form of a single pigmented papule or nodule. Histopathologically shows the differentiation of pigmented hair shaft in an epidermal cyst. Although benign, pigmented follicular cyst can affect the quality of life of a person if the appearance of multiple and symptomatic. This is the twice case in a 5-year period (2015-2019) in Dr. RSUP. M. Djamil Padang. This disease clinically resembles multiple steatocystoma, so histopathological examination is needed to confirm. Case report: A 26 years old female, complained of appearing bluish and yellowish lumps that sometimes felt painful on her chest, stomach, trunk, both of leg, both of arm, which increase in number and size since ± 5 years. These lumps secreted white-yellowish mass if rupture. Working diagnosis of this patient was suspect steatocystoma with differential diagnosis with multiple follicular cyst, eruptive xanthoma. We diagnosing with multiple pigmented follicular cyst after histopathological examination showed a cyst on dermis with thin epithelial wall and lumen containing laminated keratin and pigmented hair shafts. There was no presence of sebaceous gland on PAS stain. Discussion: Clinically, it is difficult to distinguish multiple steatocystoma from multiple epidermal cysts. Histopathology of this patients is suitable for multiple pigmented follicular cyst, which is a rare variant of multiple epidermal cyst.