Eruptive Vellus Hair Cyst in Patients with Chronic Renal Failure

Abstract

Two cases of eruptive vellus hair cysts associated with chronic renal failure are reported. Histologically the lesions of both cases showed cystic structures in the dermis lined by squamous epithelium which contained varying amounts of vellus hair shafts. Immunohistochemical studies using monoclonal anti-AGE (advanced glycation end product) antibody demonstrated that keratinous materials within the cystic structures were immunoreactive to the antibody, whereas those of cystic lesions (epidermal cyst, eruptive vellus hair cyst, steatocystoma multiplex, trichofolliculoma and trichilemmal cyst) seen in otherwise healthy individuals were negative. Because it has been reported that plasma and skin levels of AGE are elevated in renal failure patients, AGE-modified keratinous materials may be associated with the formation of cystic structures by stimulating the occlusion of the epithelium.

Eruptive Vellus Hair Cysts: Report of a New Case with Immunohistochemical Study and Literature Review

“…Most EVHC are acquired and sporadic, appearing in the absence of triggering factors such as trauma or irritation [1,2,3]. They are occasionally associated with other genodermatoses, such as SCM (14 cases) [2], pachyonychia congenita [12], ectodermal dysplasia [15], oculo-cerebro-renal (Lowe) syndrome [16], and with chronic renal failure [17]. Esterly et al [1] hypothesized that a particular developmental abnormality of the vellus hair follicle predisposes it to infundibular occlusion, resulting in retention of vellus hairs and keratin into the newly formed cavity.…”

“…Acquired EVHC could result from increased proliferation or differentiation of follicular keratinocytes, following stimulation by local or systemic factors. Such infundibular keratinization trigger factors could include advanced glycation end product in chronic renal failure [17], and lysosomal enzymes in Lowe syndrome [16]. Advanced glycation end product might activate follicular keratinocytes, thereby favoring the development of cystic lesions following minor trauma or scratching [17].…”

“…Such infundibular keratinization trigger factors could include advanced glycation end product in chronic renal failure [17], and lysosomal enzymes in Lowe syndrome [16]. Advanced glycation end product might activate follicular keratinocytes, thereby favoring the development of cystic lesions following minor trauma or scratching [17]. In Lowe syndrome, the deficiency in phosphatase leads to the extracellular deposition of lysosomal enzymes, so that the cysts could result from a localized attempt to wall off these enzymes [16].…”

Eruptive vellus hair cysts on the face: a case report and literature review

“…Irk ve cinsiyet ayrımı gözetmeyen hastalık olguların çoğunda sınırlı kalır ve benin seyir gösterir 5 . Bununla birlikte EVKK'nin anhidrotik ve hidrotik ektodermal displaziler 9,10 , pakionişi konjenita 11 , Lowe sendromu 12 gibi hastalıklarla ve kronik renal yetmezlikle birliktelikleri görülmüştür 13 . Lezyonları yüzde sınırlı kalıp yayılmayan olgumuzda muayene ve laboratuvar incelemeleri sonucu eşlik eden başka bir hastalık yada patolojik duruma rastlanmadı.…”

“…Beş (%25) hastada eşlik eden başka bir hastalık (milia, steatokistoma multipleks, atopik dermatit, anhidrotik ektodermal displazi, diyabet ve kronik böbrek yetmezliği) izlendi. Hastaların 13'ünde (%65) lezyonların rengi deri renginden farklıydı, sadece birinde subjektif yakınma olarak kaşıntı mevcuttu 2,[6][7][8]13,14,16,[19][20][21][22][23][24][25][26] . Lezyonlardaki ağrı ve hassasiyete bizim olgumuz dışında rastlanılmadı.…”