CO2 laser therapy in a case of steatocystoma multiplex with prominent nodules on the face and neck

Fractionated ablative carbon dioxide laser treatment of steatocystoma multiplex

Steatocystoma multiplex is a well-recognized condition in which subjects develop dermal cysts generally inherited in an autosomal dominant fashion, though these can occur sporadically. This case report describes the successful treatment of a 51-year-old woman with steatocystomata limited to the face, who after two treatments with a fractionated ablative carbon dioxide laser remained free of cysts for three years. We conclude that this treatment should be considered as an efficient and effective treatment option for patients with steatocystoma multiplex.

Steatocystoma multiplex

A 40-year-old man presented with multiple papules on his head and neck. The lesions had been present for about 15 years. The patient was treated for acne for 6 months, but no improvement was noted. A biopsy was performed and microscopic findings were consistent with steatocystoma multiplex.

A modified surgical technique for steatocystoma multiplex

Background:

Steatocystoma multiplex (SM) is a disorder of the pilosebaceous unit characterized by multiple sebum-containing dermal cysts. Different surgical modalities like cryosurgery, aspiration, surgical excision, incision with a surgical blade or sharp-tipped cautery followed by expression of cyst contents and forceps-assisted removal of the cyst wall and carbon dioxide laser have been used in the past.

Aims:

To study the efficacy of a modified surgical technique in the treatment of steatocystoma multiplex.

Materials and Methods:

We have used a simple modified surgical technique using a radiofrequency instrument as the incision tool for the treatment of SM in two patients.

Results:

The results were cosmetically excellent with no complications developing during or after the procedure. No recurrences were observed after five and half months of follow-up.

Conclusions:

This is a simple, easy, fast office-based procedure that is associated with minimal blood loss and post inflammatory hypo or hyperpigmentation and scarring are practically absent.

Late onset of a facial variant of steatocystoma multiplex - calretinin as a specific marker of the follicular companion cell layer

Steatocystoma multiplex is a rare,almost exclusively autosomal dominant disease of the sebaceous glands. The sites of predilection are the sternal region, upper back, axillae and proximal parts of the extremities. A 78-year-old woman developed multiple yellowish nodules only on the face over a few months. Histology revealed large cysts with a thin wall and connection to sebaceous glands. Immunohistochemical analysis showed the inner epithelial layer of the cysts was positive with calretinin.With curettage and CO2 laser therapy, a good cosmetic result was achieved.This is the first case report in the German literature of a rare sporadic form of steatocystoma multiplex with late onset and exclusive localization in the face.

Case of acne conglobata successfully treated by CO2laser combined with topical tretinoin therapy

Acne conglobata is an uncommon disorder characterized by the presence of nodulocystic lesions. Conservative therapy with oral and topical antibiotics is of limited efficacy in many cases, and surgical excision is often needed for removal of the cystic lesions. Treatment is particularly difficult in cases with lesions located in aesthetically sensitive areas, such as the face. We successfully treated a case of acne conglobata by CO(2) laser ablation to remove the top of the sinuses and their tracts. In addition, topical tretinoin therapy was also initiated simultaneously to prevent the appearance of new acne lesions. Based on the results, we propose that the use of CO(2) laser for opening the cysts, combined with topical tretinoin therapy to prevent the appearance of new lesions, is a powerful treatment option for acne conglobata.