Dr Sarma’s guide to mastering

Dermal cyst
 Epidermal cyst

Dermal cyst lined by epidermis with granular layer and containing flakey keratin.
 Pilar cyst ( Trichilemmal cyst)

Dermal cyst lined by less basophilic trichilemmal epithelium containig compact

pilar type keratin. Calcification is common.
 Infundibular cyst (Pilar cyst, infundibular type)

Pilar cyst close to the epidermis arising from the infundibulum of the hair.
Lined by trichilemmal (LT) as well as epidermal epithelium with granular layer (RT)
Content of the cyst: Compact keratin.
 Epidermal and pilar cyst

Compare the epidermal cyst

with normal epidermis.
Compare the pilar cyst with
normal hair.
 Dermoid cyst

Dermal cyst lined by epidermis with all normal adnexal structures.

Lumen contains flakey keratin and hair.
 Epidermal, pilar, dermoid cyst compared

Epidermal cyst: Pilar cyst: Dermoid cyst:

1. Lining: Normal epidermis
with granular layer. No
adnexal structure.
2. Content: Flakey keratin.
1.Lining: Paler trichilemmal
epithelium, no granular
layer.
2.Content: Compact keratin
1. Lining: Epidermis with
adnexae.
2. Content: Flakey keratin,
hair.
 Ruptured epidermal cyst

Dermal cyst lined by giant cells, histiocytes,sometimes residual epidermis

containing flakey keratin within the cyst cavity.

D
 Hidrocystoma

Dermal cyst lined by small cuboidal cells of sweat duct. Cyst cavity contains
fluid ( sweat ), but no keratin.
 Steatocystoma

Multilocular dermal cyst lined by wavy squamous epithelium with sebaceous

glands. Cyst cavity contains oily fluid, but no keratin. Origin of this cyst is the
sebaceous gland duct.
 Hidrocystoma and steatocystoma

Compare and contrast side by side.