Trichilemmal cyst in the eyelid: A rare presentation Article in - PDF document

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/274174748 Trichilemmal cyst in the eyelid: A rare presentation Article in International Journal of Ophthalmology · September 2009 DOI: 10.3969/j.issn.1672-5123.2009.08.006 CITATIONS READS 3 149 4 authors , including: Karuppannan Bashkaran Bakiah Shaharuddin Universiti Sains Malaysia Universiti Sains Malaysia 4 PUBLICATIONS 66 CITATIONS 64 PUBLICATIONS 121 CITATIONS SEE PROFILE SEE PROFILE Zunaina Embong Universiti Sains Malaysia 71 PUBLICATIONS 81 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: Improper Technique of Eye Drop Instillation Leading to Corneal Ulcer in a Visually Impaired Glaucoma Patient View project Cornea stem cells View project All content following this page was uploaded by Zunaina Embong on 29 March 2015. The user has requested enhancement of the downloaded file.

Int J Ophthalmol , Vol. 9, No.8 , Aug. 2009 rvwrv. fJO. cn Tel1029-82245L72 83085628 Emrril : I.Jf). 2000 @ 163. com Case reprirt Trichilemmal cyst in the eyelid; a rare presentation Bashkaran Karuppannon I , Bukiuh Shaharuddinl , Embong Zunainat , Venkatesh Ramaswarny lVaik2 1I)epartrnent of Ophthalmology, School of lVledical Sciences, eye lid measuring about 15mm x l0mrn x 10mrn ( Figure I ). There was no ulceration noted over the skin. Exan'rinati<-rn of Universiti Sains Nlalaysia, Health Campus, 16150 Kubang Kerian, Kelanlan, Malaysia the rest of the anterior and postr:rior segmeuls rvas unremar- 2 Depaltment of Pathoiogy, Schno.l o{ Medical Scierrces , kable. Left eye was essentially nonnal. Systernic exarnination Universiti Sains Malaysia, Health Carnpus, 16150 Kubang revealed normal findings. An excision biopsy of the mass wirs perlirrnred uncler iocal Kerian, Kelantan, Malaysia anaesthesia. Unfortunately the srveiling ruptured during Correspondence to: Ernborrg Zunaina. Departrnenl of Oph- separation releasing clieesy yellorvish iluid. 'fhe cyst was thalmology, School of Medical Sciences, Universiti Sains ' lVlalaysia, Health Campus, 16150 Kubang Kerian, Kelantan, removed and sent for histopathological examitralion. Grossly, the mass measured 10mm x l0rnm x 5trln ancl luas grayish .*--'{alaysia. zuneina@ kb. usm, my brorvn in colour. 'Ihere rvas presencr) of cysric spaces. - Received r2009-05-13 Accepted .2009-07 -28 Histopathological findings reveaied Iragnrents of fil:rocolla- genous tissue containing a cyst. The cyst was linell i:y Abstract stratified squamous epitheliunt with abrupt keratinizatiorr .,A,42-year=old Malay lady presented with a Z-year history ( Figure 2 ). Uneven interphase betrveen lteratinized and of painless and progressive right upper lid swelling. There nonkeratinized cells also noted ( Figule 3 ) . 'I'here was no was Ro history of trauma or similar lesion elsewhere, An excisional biopsy of the mass was performed and the granuiar celi layer or giandular tissue note;d. The cyst histopathological findings of the excised lesion were contained keratin material, e onsistent with those for a trichilemmal cyst, A diagnosis of trichilernmal cyst was made based on the Trichilemmal cyst, although rare should be considered in histopathological findings. Patient tr,as reviewed trvo rveeks any case of eye lid lesion, later. The wound heaied well and the eyelid was norrtral r KEWVOftDS, triehilemmal cyst; eye lid; pilar cyst ( Figure 4 ). There was no recurrence of the swelling noted pOI: 10. 3969/j. issn, 1672-5123. 2009. 08. 006 aftel one and a half years of observation. DISCUSSION Karuppannar ts, Shaharuddin Il , Zunaina Il, Naik VR. Trichilernmal I'here are many types of benign and malignant turnours that cyst in the eyelid;a rare presentation.Int I Ophthalmol (Cuoji Yanke can occur in the eyelids. Chalazia, epirlennal inclusion cysts, Tazhi ) 2009 i9 (8) l45l -t 452 sebon'heic keratoses and apocrine hydrocystomas are the mosl common berrign lesionslo] . INTRODUCTION Trichilemmal cysts occur most cornmonly on the scalp due io rp richilemmal cysts &re also known as pilar cysts. They are abundance of hair follicle. They can also occur ol1 other paris I common benigu tumors occurring mainly on the scalp. It of the body except the palms, soies, ger.ritalia, axillae and presents as smooth , mobile, firm and round nodule without a groins t'1. Trichilemmal cysts involving'the skull bases, pulp visible puncium, containing keratin and its breakdorvn of index firrger and upper lip have also been reporteil [2'3'6]. products I'''1 . 'Tri"lrilemmal cyst arises from the outer root Trichilemrnal cysts were previously consitlered sebaceons' or sheath ( tlichilemma) of the hair follicle i'l . Th"." is often an epidemroid cysts and were historically referred to by the autosomal dominant inhelitance pattern as the lesion is common name of ,u",.['] . Trichilemmal cyst needs to he diffe- frequently familioi i'''l . rentiated from epidermoid cyst. Trichilemrnal and epiderrnal To the best of our knowledge, no cases of trichilemmal cysts cysts are both keratinous cysts. Clinically trichilemrnal cysts involving the eyelid have been reported. We report a rare case and epidermal cysts have similar presental.ion. However they of trichilemrnal cyst iocatecl in the upper eyelid. differ histopathologically in which trichilemrnal cysts do not have granular cell Iayer l6l. Approxirnately 20a/o of CASE REPOITT A 42-year-old Malay lady presented with history of progressive epithelial cysts are trichilemnral cysts and the other 804/o are epidermoid i'1. There are reporte(l r:ases r.rf prolilerating painless srvelling over the right rrpper eyelid over a perir-,d of two years. It rvas not associatecl with redness, discharge or trichilemmal cyst and malignant prolifclaling trichilernrnal tumoul of the eyelicl it'el blurring of vision. T'here rvas no history of trautna or similar . lesion elsewhere. 'fhere was no family tristory ol sirnilar 'l'o our knowledge, no cases oi'trichilenrnial cysls involviug the eye lid have been described. 'Ihe unitlueness of this case is lesion. On clinical examination of the right eye, there n'as a due to its rare site of presentation. It is not possil-rle to cotrfitrrr cystic, fieely rnobile, non tender s'n'elling over the right upper

ffi96 HBF.E www.lJo.cn trJlI6R6+*ffi 200e ffB tr Bi6:029-822 451 72 83085628 Q,5{EfiE : lJo. 2000@ 163. com :l;:;1 ,ij.l t:t tt t: ':: ii:,:{:F,*i:l,aii the diagnosis of evelicl lesions basecl on the clinical findings alone. Tl.rus all excised e--velicl lesions sirould be sLtbmitted for histopathoLogical exanrination f'ol. 'llhis case highlights the r.reed for the ophthahnologists to bear in rnind the rare lesion-" in the eyelid. RERERBNCES 1 Ikizoglu G. Kaya'fI , 'firrsen U, Baz K. 'l'he use of the {iecr dissector for the removal of trichilemnral cysts. Int Jof Dennatol 2003 i42 (5 ) $A5' 407 2 PerezLM, Bmce JW=, Murah VA. Trichilemmal oy-"t of the upper iip. Oral Surg Oral Merl Oral Pathol Oral lladiol Endod 1997;84( 1 ) :58-60 3 L1-llahv K, Ishak E. 'llrichilemrnal cysL invoh'ing the skull hase.Acta Neurochit Nien ) 2004;\46( 12) ;1361-1364 " Figure 1 Trichilernmal cJ/st of the right upper eye lid ( arrow) 4 Ilernardini FP. Ilanagement of malignatrt and henign e,velid lesions. Curr Opin Ophthalmol 2006 i17(-5 ) :480-484 5 Leppard BJ. Sanrlerson KY. I'he natural history of tricirilemrnai c)-.ts. Br J Dennatol 1976i94(4) : 3'79-390 6 ikegami T, Kameyama il'l . Orikasa FI, Yamazaki K. Trichilemmal c-vst in ihe pulp of the index finger.Hand Surg 2003;8(2) :253255 7 Satyaprakash AK. Sheehan DJ, Sang eza OP. Proliferating ti:ichilemmal tiiinors: a r:evien of the literature. Dennatol Surg 2007 ;33 (9):ir02-1108 8 Kang SJ. Vojno 'IH, Grossniklaus I:lE. Prolifelating trichiletrmal cyst of the eyelid.zlrr I Ophthalmol 2007;143 (6) :1065-1067 9 Lee SJ, Choi KH, Han JH, Kirn YD. lialignart proliferating trichilenrmal tumor of the iower eye1.id. Ophthal Plast Reconstr Surg' 2005 t2l (5 ) ,349-352 l0 Kersten RC, Ewing-Chow D, I(uhvin DR. Gallon I'[. .Accuracv of grrre 2 C;'st rras lined by squamous epithelium. Abrupt clirricai diagnosis of cutaneous eyelid lesjons.Ophthalnology 1997 1104 keratinisation is seen. ( HE x 10 ) (3) A19-484 +A,H!HRHS4frHEq' 1 I'\ Bashkaran Karuppannanr , Bakiah Shaharuddinr , Embong Zu- nainar , Venkatesh Rarnasrvamy Naikz ( {F& #ln, gx tFtrE Y J+, q xEi u rsfll./t# lE+ &i' ER f+;'ffir.BFl.) )ilIl"tF-*- iEmbong Zttttaina. zunaina@ kb. rrsm. rny 7t6i* H,*,k,42 Y, er * It'ffi +*t R++b _E ES,{'i ffi 2a kji ^, xb ,Tt,tl(fi F, H 1*lX',fu.fu7.€t++ffi +fr" )t"11F,+ +'1mW'fr q,rf,tttr,tE rRffi,E++,16?, X.E,tr h +,k*f,+ *q"+A r,+ " + h.R fr+, E-E + L,EaR &fr T. + # 44 F.4t:. [igure 3 interyrhase bet*ren keratinized and nonkeratinized lJneven Xil+iFl |+kF;i4'; fl,E ES |#,+,RI'f cells ( IIE x40 ) View publication stats View publication stats