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Steatocystoma multiplex is a rare skin disorder characterized by the development of numerous cysts, which usually start at puberty. It is believed that the hormonal changes that occur during puberty may trigger the changes, which involve the pilosebaceous unit in the skin, or the hair follicle and its associated oil gland. However, although most cases are diagnosed among patients who are between 20 and 30 years old, some have reported cases that were found at birth or old age. Steatocystoma multiplex is an inherited condition, and both male and female may be affected. Sporadic cases also occur.

Steatocystoma multiplex is a benign condition (not cancerous) that usually does not affect one's general health. However, widespread lesions may have a psychological effect because it can affect one's skin appearance, which can result in anxiety. Affected individuals complain about developing many tiny cysts that are smooth and yellowish. These cysts are non-tender and otherwise asymptomatic. Occasionally, some lesions enlarge and rupture under the skin, become inflamed, and form tracts. Cystic contents are usually oily and odorless, but secondary bacterial infection can lead to a smelly discharge. This condition is also called steatocystoma suppurativa. Scarring can occur.

Steatocystoma multiplex cysts are usually found in areas where sebaceous glands are numerous, most commonly in the chest, armpits, neck, and arms. Single cysts are called steatocystoma simplex. Localized steatocystoma multiplex cysts in the scalp, face, behind the ear, groin, and around the nose have also been reported. The cysts may appear similar to other skin conditions such as acne, milia, and other skin tumors and cysts.

Treatment

Steatocystoma multiplex is an inherited condition that may be triggered by hormonal changes during puberty. There is no specific diet that can prevent or treat its occurrence.

Most patients seek treatment for cosmetic reasons. The small cysts, although painless, can enlarge and form tracts under the skin. Treatment is indicated for inflammation and infection, and the aim is to prevent scarring.

Oral isotretinoin (a retinoid-like agent) such as Amnesteem, Myorisan, Claravis, and Sotret decreases the size of sebaceous glands and reduces sebum production. It may also help to reduce inflammation and temporarily shrink the cysts. However, only doctors who are trained and registered to use it can prescribe and dispense the drug because it is associated with potentially dangerous side effects.

Oral antibiotics such as tetracyclines may also be prescribed to treat infection and reduce inflammation. These drugs are effective in treating many types of bacterial infections. They also have an anti-inflammatory effect.

Cysts may be individually removed through surgery, using small incisions to drain the cysts. Other methods to remove cysts include simple needle aspiration, electrosurgery, carbon dioxide laser ablation, or cryotherapy. One study showed that carbon dioxide laser ablation led to good cosmetic results with no recurrences during a follow-up period of 18 months.

The prognosis for steatocystoma multiplex is excellent, with no reports of malignant transformation.

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