Trichilemmal Cyst

Aka: Trichilemmal Cyst, Scalp Cyst, Pilar Cyst, Wen, Proliferating Trichilemmal Tumor

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II. Epidemiology

  1. Most common in over age 15 years
  2. Family History predisposes to multiple Trichilemmal Cysts

III. Pathophysiology

  1. Intradermal cyst involving the scalp in 90% of cases
  2. Similar to Epidermoid Cysts
  3. Most common in areas of dense Hair Follicles
    1. Derives from outer Hair Follicle root sheath

IV. Symptoms

  1. Asymptomatic in most cases
  2. No odor (unlike Epidermal Cysts)

V. Signs

  1. Well defined, scalp oval mass
  2. Scalp Cysts collect keratin of cheese consistency
  3. Multiple Scalp Cysts may coalesce
  4. May become inflamed if rupture occurs
  5. Often associated with overlying regions of Alopecia
  6. Most lesions are slow growing and benign (except Proliferating Trichilemmal Tumor)

VI. Findings: Variants

  1. Proliferating Trichilemmal Tumor
    1. Rapidly growing lesions with overlying inflammation
    2. Complete surgical excision (risk of malignant transformation)

VII. Differential Diagnosis

  1. Epidermoid Cyst
  2. Lipoma

VIII. Management: Excision

  1. Complete excision in standard fashion
  2. See Minimal Epidermal Cyst Excision

IX. References

  1. Habif (1996) Clinical Dermatology, p. 644-5
  2. Wagner (2024) Am Fam Physician 110(4): 353-61 [PubMed]

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Related Studies

Ontology: Epithelial cyst (C0014511)

Definition (MSH) Intradermal or subcutaneous saclike structure, the wall of which is stratified epithelium containing keratohyalin granules.
Concepts Anatomical Abnormality (T190)
MSH D004814
ICD9 706.2
ICD10 L72.0 , K09.8, L72.3
SnomedCT 416292009, 419893006, 201231006, 390838001, 156420007, 87595009, 87373006, 254672005, 201324005, 390837006, 418323001, 399999000, 419603000, 419670003, 417992006, 418630001
English Wen, Cysts, Epidermal, Cysts, Epidermoid, Cysts, Sebaceous, Epidermal Cyst, Epidermal Cysts, Epidermoid Cyst, Epidermoid Cysts, Sebaceous Cyst, Sebaceous Cysts, Cyst, Epidermal, Cyst, Epidermoid, Cyst, Sebaceous, EPIDERMOID CYSTS, Epidermoid cysts, sebaceous cyst (diagnosis), sebaceous cyst, Cyst epidermal, Cyst sebaceous, Infundibular Cyst, Epidermal Cyst [Disease/Finding], sebaceous cysts, Cyst;epidermoid, Cyst;sebaceous, epidermal cyst, keratin cyst, cyst epithelial, epithelial cyst, cysts epithelial, cysts keratinous, epidermoid cysts, epidermal cysts, wen, wens, keratinous cyst, Epidermal cyst (disorder), Keratinising cyst, Keratinizing cyst, Keratinizing cyst (disorder), Epithelial cyst, cyst; epidermal, cyst; epithelial, cyst; sebaceous, epidermal; cyst, epithelial; cyst, sebaceous; cyst, Epidermal cyst, NOS, Epithelial cyst, NOS, Epithelial Cyst, Keratin Cyst, Keratinizing Cyst, Keratinous Cyst, epidermoid cyst, Epidermal cyst, Epidermoid cyst, Sebaceous cyst, Keratin cyst, Keratinous cyst, Epidermoid cyst (disorder), Sebaceous cyst (morphologic abnormality), Epidermoid cyst (morphologic abnormality), Epidermoid cyst of skin (disorder), Epidermoid cyst of skin, Keratinising cyst of skin, Keratinizing cyst (morphologic abnormality), Keratinizing cyst of skin (disorder), Keratinizing cyst of skin
Spanish quiste epidermoide (trastorno), quiste epidermoide, quiste sebáceo (anomalía morfológica), quiste sebáceo, quiste epidermoide (anomalía morfológica), quiste epidermoide cutáneo (trastorno), quiste epidermoide cutáneo, quiste queratinizante (anomalía morfológica), quiste queratinizante de la piel (trastorno), quiste queratinizante de la piel, Quiste sebáceo, Quiste epidérmico, Quiste epidermoide, quiste epidérmico, quiste epidérmico (trastorno), quiste epitelial, quiste de queratina, quiste epidermoideo, lupia, quiste queratinizante (trastorno), quiste queratinizante, Quiste Epidérmico, Quiste Epidermoide, Quiste Sebáceo
Dutch atheroomcyste, epidermale cyste, epidermoïde cyste, cyste; epidermaal, cyste; epitheliaal, cyste; talgklier, epidermaal; cyste, epitheliaal; cyste, talgklier; cyste, Atheroomcyste, Cyste, epidermaal, Epidermale cyste, Talgcyste, Epidermoïdcyste
German Zyste der Haut, Atherom, Talgdruesenzyste, Zyste der Talgdruese, Epidermalzyste, Epidermiszyste, Epidermoidzyste, Talgdrüsenzyste
Italian Cisti dell'epidermide, Cisti epidermoide, Cisti sebacea, Cisti epidermica
Portuguese Quisto sebáceo, Quisto epidermóide, Quisto epidérmico, Cisto Epidermoide, Cisto Epidérmico, Cisto Sebáceo
Japanese 脂腺嚢腫, ｼｾﾝﾉｳｼｭ, ﾋｮｳﾋﾉｳﾎｳ, ﾙｲﾋｮｳﾋﾉｳﾎｳ, 外毛根鞘性嚢腫, 毛髪嚢腫, 皮脂嚢胞, 類表皮嚢胞, エピデルモイドシスト, 毛鞘嚢胞, 毛嚢胞, 外毛根鞘嚢腫, 上皮嚢胞, 外毛根鞘性嚢胞, 表皮嚢腫, 類表皮嚢腫, 粉瘤, 外毛根鞘嚢胞, 表皮のう胞, 表皮様嚢腫, 類上皮嚢腫, アテローム(粉瘤), 表皮嚢胞
Swedish Epidermoidcysta
Czech epidermální cysta, Epidermální cysta, Epidermoidní cysta, Mazová cysta, mazová cysta
Finnish Epidermaalikysta
Russian SAL'NOI ZHELEZY KISTA, EPIDERMAL'NAIA KISTA, KISTA EPIDERMOIDNAIA, VOLOSIANAIA KISTA, ВОЛОСЯНАЯ КИСТА, КИСТА ЭПИДЕРМОИДНАЯ, САЛЬНОЙ ЖЕЛЕЗЫ КИСТА, ЭПИДЕРМАЛЬНАЯ КИСТА
Korean 표피낭
Croatian EPIDERMOIDNA CISTA, EPIDERMALNA CISTA
Polish Torbiel naskórkowa
Hungarian Cysta sebacea, Epidermoid cysta, Epidermalis hólyag, Sebaceus cysta, Epidermalis cysta
Norwegian Epidermoidcyste
French Kyste épidermique, Loupe, Kyste épidermoïde, Kyste sébacé
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Pilar cyst (C0086809)

Concepts Anatomical Abnormality (T190)
MSH D004814
ICD9 704.41
ICD10 L72.11
SnomedCT 390838001, 87373006, 201231006, 156420007, 254677004, 417992006, 419603000
English Cysts, Pilar, Pilar Cysts, Cyst, Pilar, pilar cyst, pilar cyst (diagnosis), pilar cysts, wen, cyst; pilar, pilar; cyst, Pilar cyst, Pilar Cyst, Wen
Dutch harige cyste, uitwas, cyste; haarwortel, haarwortel; cyste
French Kyste sébacé, Loupe, Kyste pilaire
German Haarzyste, Talgdruesenzyste, Haarbalgzyste
Italian Cisti sebacea, Cisti pilare
Portuguese Quisto pilar, Quisto sebáceo, Cisto Pilar
Spanish Lobanillo, Quiste piloso, Quiste Pilar, quiste pilar
Japanese 皮脂嚢腫, 皮脂嚢胞, ﾋｼﾉｳﾎｳ, ﾋｼﾉｳｼｭ
Czech Tukový nádor, Dermální cysta, pilární cysta
Hungarian Cysta pilaris, Pilaris cysta
Norwegian Hårsekkcyste, Pilariscyste
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Trichilemmal cyst (C2266788)

Concepts Anatomical Abnormality (T190)
ICD9 704.42
ICD10 L72.1
SnomedCT 201232004, 201234003, 87373006, 254677004, 419093005
English Trichilemmal cysts, Trichilemmal cyst, Follicular isthmus cyst, Isthmus catagen cyst, Trichilemmal cyst (disorder), cyst; trichilemmal, trichilemmal; cyst, Trichilemmal cyst (morphologic abnormality)
German Trichilemmalzyste
Korean 모낭종
Spanish quiste tricolemal, quiste triquilémico, quiste triquilémico (anomalía morfológica), quiste tricolemal (anomalía morfológica), quiste tricolémico, quiste del istmo catágeno, quiste del istmo folicular, quiste triquilemal (trastorno), quiste triquilemal
Dutch cyste; tricholemmaal, tricholemmaal; cyste, Tricholemmale cyste
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Proliferating trichilemmal tumor (C2959585)

Concepts Neoplastic Process (T191)
SnomedCT 446023005
English Proliferating trichilemmal tumour, Proliferating trichilemmal tumor (morphologic abnormality), Proliferating trichilemmal tumor
Spanish tumor triquilémico proliferativo (anomalía morfológica), tumor triquilemal proliferativo, tumor triquilémico proliferativo
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Sebaceous Gland Disorders

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