By Gary M. White, MD
Steatocystoma multiplex (SM) is a rare disorder in which the patient develops multiple cutaneous sebum-containing dermal cysts.
The patient with SM develops multiple cysts in the subcutaneous tissues of the axilla, neck, arms, and chest. In severe cases, lesions may be distributed diffusely. The lesions tend to be soft, whitish yellow and may range from 1 mm to 5 cm in size. If ruptured, the contents may be milky white or clear and oily. Individual cysts may rupture and become inflamed. In such cases, the term steatocystoma multiplex suppurativa is used. If only one lesion is present, the term steatocystoma simplex has been used.
Currently, there is no known way to prevent the development of new lesions. The patient may benefit from surgical removal of the largest and most bothersome lesions. Various reports have described approaches for patients with hundreds of lesions. These include cryosurgery with a CryoProbe, CO2 laser, and surgical removal under general anesthesia.
In one case, a 29-year-old woman had over 50 cysts treated by local anesthesia followed by cyst puncture with a sharp-tipped cautery point and evacuation of the contents by squeezing the cyst with a fine forceps. Then, the cyst wall was grasped by the forceps and the sac was extracted through the small hole. [Int J Dermatol. 2001;40:785-8]
For steatocystoma multiplex suppurativa, antibiotics, intralesional steroids, and even isotretinoin may be given.
White viscous material or thicker, cheesy material flows from the cyst.
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