Steatocystoma multiplex occurring during a strict diet: report of a case treated with Er:YAG laser

Steatocystoma multiplex (SM) is a benign adnexal disorder characterized by multiple dermal cysts arising from the pilosebaceous unit. Although various treatment modalities have been reported, recurrence and scarring remain challenging issues. This report aims to present a minimally invasive treatment approach using Er:YAG laser therapy. A 24-year-old man presented with numerous asymptomatic, dome-shaped, skin-colored papules (3-8 mm) on the lumbar and gluteal regions, which appeared following rapid weight loss. Histopathologic examination confirmed the diagnosis of SM. Given the extensive number of lesions, Er:YAG laser therapy was selected as a minimally invasive approach. The laser was applied using a 2-mm spot size and fluence of 7 J/cm2 in micro-short pulse mode until cyst contents were expelled. Topical mupirocin and a short course of oral azithromycin were prescribed post-procedure. The patient tolerated the procedure well. At six months, complete lesion resolution was achieved without scarring or recurrence. Cosmetic outcomes were good with minimal postinflammatory erythema. Er:YAG laser treatment may represent a safe and effective option for the management of SM with excellent cosmetic outcomes and minimal recurrence, particularly in cases with numerous lesions where surgical excision is impractical.