International Journal of Research in Medical Sciences | September 2015 | Vol 3 | Issue 9 Page 2478 International Journal of Research in Medical Sciences Gautam R et al. Int J Res Med Sci. 2015 Sep;3(9):2478-2480 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Case Report Multiple palmar epidermoid cysts: fourth reported case Raj Gautam, Tanveer Parvez Shaikh*, Shitiz Gupta, Jatin Wani, Sridevi Murali, Ankit Bhupatkar, Sandesh Deolekar INTRODUCTION Multiple epidermoid cysts appear infrequently on the palms and soles where pilosebaceous structures are absent. Till date 3 cases of multiple palmoplantar epidermoid cysts have been reported to the best of our knowledge 1-3 (Table 1). Obstruction of hair follicles and implantation of epidermal fragments into the dermis from a penetrating or blunt injury have been pointed out as causes of common epidermal cysts. 4 However, it is improbable that palmoplantar epidermoid cysts develop from pilosebaceous structures. On the other hand, recent investigations indicate that palmoplantar epidermoid cysts are caused by human papillomavirus (HPV) infection 5-10 and that they develop from eccrine ducts. 1,9,11 Here we report fourth case of multiple palmar epidermoid cysts. CASE REPORT A 55 year old woman came to outpatient department after first noticing asymptomatic multiple nodules on the left palm of her left hand since 10 years. These nodules gradually enlarged and increased in size over 10 years. She had noticed no striking traumatic injuries at the sites where the epidermoid cysts developed. The cysts were varied in size, smooth-surfaced, dome-shaped well defined margins (Figure 1). Table 1: Summary case reported. Year (reference) Age (sex) Location Duration Therapy 1994 (1) 23 year (male) Right sole ?? Surgery 1998 (2) 25 year (male) ?? ?? Surgery 2002 (3) 65 years (female) Left hand 2 years Surgery 2015 (Present) 55 years (female) Left hand 10 years Surgery Fine Needle Aspiration Cytology (FNAC) revealed white creamy material suggestive of epidermoid cyst. Ultrasonography showed two well defined lesions largest 2x2 cm. No similar nodules and verrucous lesions were observed on any other part of her body surface. These two lesions were excised (Figure 2) and sent for ABSTRACT Implantation of epidermal fragments into the dermis has been pointed out as the cause of common epidermal cysts. However, some palmoplantar epidermoid cysts have been reported to be caused by human papillomavirus (HPV) infection or to be derived from eccrine ducts. A 55 year old woman presented with multiple epidermoid cysts on the palm and volar aspect of her left hand. HPV infection CEA was not detected in situ hybridization and polymerase chain reaction. Keywords: Epidermoid cyst, Eccrine duct, CEA, Human papillomavirus Department of Surgery, DY Patil School of Medicine, Nerul, Navi Mumbai, Maharashtra, India Received: 04 July 2015 Accepted: 09 August 2015 *Correspondence: Dr. Tanveer Parvez Shaikh, E-mail: drtanny.shaikh@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150656