Eruptive vellus hair cysts (EVHCs) are rare epidermal cysts with vellus hairs that may be inherited or acquired.1>z Eruptive vellus hair cysts were first identified three decades ago and are considered a developmental anomaly of follic-ular occlusion.2'3 Acquired EVHCs have rarely been reported. We describe a case of acquired EVHCs initially misdiagnosed as steatocystoma multiplex (SM).A 41-year-old woman presented with a three month history of a slowly progressive pruritic eruption on her chest and neck. She had been in good general health, with no pertinent past medical history. There was no family history of EVHCs. On physical examination, the patient was a thin-appearing, African-American woman. Complete dermatologic examination revealed multiple dome-shaped hyperpigmented to flesh-colored papules on the upper chest and lateral neck (Fig. i). A biopsy from a lesion on the chest revealed a cyst lined by epithelium identical to the epidermis and to the infundibulum of the hair follicle. Laminated keratin and numerous vellus hairs were present within the cyst (Fig. 2).
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