The First Report of Multiple, Bilateral Axillary Epidermal Inclusion Cysts.

Area of Science:

• Dermatology
• Pathology

Background:

• Epidermal inclusion cysts (EICs) are common benign skin tumors, frequently associated with acne or blocked hair follicles.
• While typically sporadic, multiple EICs can indicate underlying syndromes or arise post-procedure.
• Malignant transformation of EICs, though rare, necessitates complete surgical excision due to potential complications like rupture, pain, and infection.

Observation:

• This report details a unique case of a patient presenting with multiple, bilateral, and painless epidermal inclusion cysts in the axilla.
• Notably, the patient had no prior history of acne, axillary surgery, or known genetic syndromes predisposing to EIC development.

Findings:

• The occurrence of multiple, bilateral axillary EICs in the absence of typical risk factors is an unusual clinical presentation.
• This case expands the differential diagnosis for axillary masses and highlights the possibility of EICs arising in atypical locations and contexts.

Implications:

• This case underscores the importance of considering epidermal inclusion cysts in the differential diagnosis of bilateral axillary masses, even without typical predisposing factors.
• Further investigation may be warranted to understand potential novel pathways or triggers for EIC formation in such cases.
• Complete excision remains crucial for definitive management and to prevent complications, regardless of the cyst's location or associated risk factors.