LAUSR

Dear Editor, Cutaneous cysts are classified according to the lining epithelium, the type of keratinization, and the presence of vellus or terminal hair. In the perianal region, epidermal cysts are uncommon, while multiple cysts are rare. We describe a 76-year-old male patient who presented with a cutaneous squamous cell carcinoma (SCC) of the helix for Mohs surgery. On clinical examination, we observed multiple yellow to brownish tiny cysts of the perianal skin (Figure 1). These cysts were asymptomatic with a smooth surface and a diameter of 1 to 3 mm. No trauma or rubbing was reported. The lesions lasted at least for 1 year. No treatment was used. We performed a diagnostic proctoscopy to exclude involvement of the rectal mucosa. We observed no pathologies up to 12 cm upwards the anal sphincter. A skin biopsy was performed. The histologic investigation revealed an epidermal cyst of the mid-dermis lined by stratified epithelium and containing laminated keratin and vellus hairs. The diagnosis of multiple vellus hair cysts of the perianal skin was confirmed (Figure 2). Laser ablation was suggested. However, no further treatment was warranted by the patient. 1 | FC DR DISCUSSION