Steatocystoma multiplex suppurativum: Oral isotretinoin treatment combined with cryotherapy

Abstract

A 30-year-old man presented with numerous papules, nodules and inflamed cysts. The lesions were located all over the body, including the scalp, except the palms and soles. His mother and one sister had had similar but less extensive lesions. Histopathology of the biopsy specimens obtained from the anterior chest wall, axillae and the back region was consistent with steatocystoma multiplex (SM). A diagnosis of steatocystoma multiplex suppurativum was made. The inflamed lesions were treated with oral isotretinoin (1 mg/kg per daily) for 6 months. At the same time, cryotherapy was used for non-suppurating lesions smaller than 2 cm. When the patient was evaluated 6 months later, cosmetic results were good. No new lesions have appeared in the subsequent 12-month follow up.

Off-label uses of retinoids in dermatology

“…When the patient was evaluated 6 months later, cosmetic results were good. No new lesions have appeared in the subsequent 12-month follow up [92].…”

Fractionated ablative carbon dioxide laser treatment of steatocystoma multiplex

“…Incision of steatocystoma with a radiofrequency device or surgical blade incision with removal using a vein hook have both been successful without recurrence or scarring, but these methods require treatment to each singular cyst and therefore are very time consuming to perform (8,9). Finally, oral isotretinoin has also been utilized as a treatment for the suppurative form of SM (10–14) with good cosmetic result, but adverse reactions such as worsening in the size and number of cysts have been reported (12,13). …”

Steatocystoma Multiplex: Case Report and Review of Treatment

“…1 Inflamed and suppurative lesions respond well to isotretinoin; however, non-inflamed cystic lesions remain unchanged after isotretinoin treatment. 5 The antiinflammatory effect of isotretinoin likely accounts for this finding.…”

“…1 Although SM can involve any portion of the body, areas with a high number of sebaceous glands, including the neck, trunk, axilla, groin, scalp, and proximal extremities are commonly affected.…”

“…2 In a subtype of SM, referred to as steatocystoma multiplex suppurativa, cysts can become inflamed and subsequently rupture, leading to secondary infection and abscess formation. 1 Keratin 17 is an intermediate filament found in the epithelial cells of the nail bed, hair follicle, and sebaceous gland. 3 Pachyonychia congenita (specifically, pachyonychia congenita KRT17, formerly known as pachyonychia congenita type 2) and SM have both been associated with a mutation in the gene encoding keratin 17.…”