Pilar cyst on the dorsum of hand: A case report
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Pilar cyst mainly occurs on the scalp, but pilar cyst on the dorsum of hand has not been reported. Pilar cysts are identified by Pinkus as the keratinization of the outer root sheath of hairs, which were originally called sebaceous cysts. The cysts are characterized by smooth, round nodules with solid texture and good mobility.

A 76-year-old man presented with a flesh-colored, dome-shaped nodule on the opisthenar of his right hand, which had gradually increased in size for two months. The patient did not have any subjective symptoms. The patient is generally in good condition. No changes in diet, sleep, urination, defecation, or body weight could be found. Physical examination showed that the patient possessed stable vital signs.

A dermatological examination revealed a skin-colored nodule with smooth surface on dorsum of his right hand. This soybean-sized nodule was tough in texture with clear boundary and no hair follicle. A histopathological examination was conducted and the pathology showed that the cyst was in the reticular dermis, with surrounding basal cells arranged as a fence.

Clinically, it was considered as dermatofibroma at first. Based on histopathological examination, a diagnosis of pilar cyst was made. Complete excision under local anesthesia was done. After the treatment, the patient achieved complete recovery with no relapse during the 6 months of clinical follow-up.

Source: https://journals.lww.com/md-journal/subjects/Dermatology/Fulltext/2020/07310/Pilar_cyst_on_the_dorsum_of_hand__A_case_report.122.aspx