Ultrasonographic Spectrum of Cutaneous Cysts With Stratified Squamous Epithelium in Pediatric Dermatology: Pictorial Essay

Abstract

High‐resolution ultrasound (HRUS) is an important diagnostic method in dermatology, especially in pediatric population. The most common type of cutaneous cysts in children corresponds to cysts with stratified squamous epithelium (CSSE). The objective is to present the different ultrasonographic appearance of histologically proven CSSE in a retrospective review. Epidermoid, milium, trichilemmal, dermoid, and pilonidal cyst and steatocystomas are included. Utility of HRUS in diagnosis of cutaneous lesions is well established. It is important to know—and stay updated—about the wide spectrum of ultrasonographic appearance of CSSE in order to avoid misleading diagnoses.

Ultrasound Assessment of Skin Tumors Local Recurrence

“…These abnormalities include postsurgical collections (seroma, hematoma, lymphocele), steatonecrosis (particularly in body areas with a thick subcutaneous layer), postamputation neuroma, granulomas (including foreign body ones), hypertrophic scar and keloid, epidermal inclusion cyst (Figure 9). 12,37,38 This is important because, for example, PET-CT imaging of CM may present false positives due to inflammation or false negatives due to lesions that measure <5 mm. Furthermore, PET-CT has a lower axial spatial resolution than ultrasound.…”

The Value of Ultrasound for Differentiating Trichilemmal Cysts From Epidermoid Cysts

“…Dermoid cysts are round or oval, well‐circumscribed with anechogenicity and flocculent echogenicity. Typically, dermoid cysts are located in the subcutaneous tissues 14,24 . Steatocystomas are often located in the chest, upper extremities, and axillas.…”

“…Steatocystomas are often located in the chest, upper extremities, and axillas. They are usually well‐circumscribed with lateral shadows, showing hypoechoic lesions with an anechoic zone inside 24,25 . Pilomatricomas most commonly occur on head, neck, and extremities with a preponderance of children and adolescents.…”

“…Typically, dermoid cysts are located in the subcutaneous tissues. 14,24 Steatocystomas are often located in the chest, upper extremities, and axillas. They are usually well-circumscribed with lateral shadows, showing hypoechoic lesions with an anechoic zone inside.…”

“…They are usually well-circumscribed with lateral shadows, showing hypoechoic lesions with an anechoic zone inside. 24,25 Pilomatricomas most commonly occur on head, neck, and extremities with a preponderance of children and adolescents. On gray-scale US, pilomatricomas often show solid nodules with patchy or scattered punctate hyperechogenicity caused by calcium deposition.…”