Case Study: Pilar Cyst, Benign Nevi, and Sun Damage in a 37-Year-Old Female
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we routinely evaluate patients for skin lesions to identify both benign and potentially concerning findings. This case highlights a 37-year-old female presenting for a comprehensive skin exam, with findings including a pilar cyst, benign moles, lentigines (sun spots), and seborrheic keratosis.
Patient Presentation
A 37-year-old female presented as a new patient for evaluation of brown skin lesions present throughout the body. The lesions had been present for years, were moderate in severity, and had not been treated in the past. She reported no personal history of skin cancer.
Dermatologic Examination
A full-body skin exam was performed with a dermatoscope. Key findings included:
Pilar Cyst: A firm, subcutaneous cyst located on the mid-occipital scalp.
Benign Nevi (Moles): Symmetrical, evenly pigmented macules and papules throughout, including a 4 mm mole on the left midback, documented for monitoring.
Lentigines (Sun Spots): Reticulated, light tan macules distributed in sun-exposed areas.
Seborrheic Keratosis: A pigmented, waxy papule and flat lesion on the right leg.
No evidence of skin cancer was noted.
Impression and Plan
Pilar Cyst
Counseling: Pilar cysts are benign keratin-filled sacs that often run in families.
Plan: No treatment required unless cyst becomes painful, red, or ruptures.
Benign Nevi
Plan: Observation, with a 6-month recheck of the mole on the back.
Counseling: Monthly self-skin checks recommended; patient advised to report any changes in size, shape, or color.
Lentigines (Sun Spots)
Plan: Emphasis on sun protection with broad spectrum SPF 30+ sunscreen.
Treatment options: Topical bleaching creams, retinoids, chemical peels, or laser for cosmetic improvement.
Seborrheic Keratosis
Counseling: Benign, age-related growths that require no treatment unless irritated or cosmetically undesired.
Key Takeaway
This case illustrates the importance of regular skin exams for early detection and reassurance. While all findings were benign, the patient received counseling on sun safety, mole monitoring, and when to seek medical attention.
At Village Dermatology in Katy and Houston, TX, we specialize in comprehensive skin exams, mole monitoring, sun protection counseling, and cosmetic dermatology for both prevention and peace of mind.
