Preauricular pit and epidermal cyst: Contrast

Deba P Sarma, MD Omaha

Preauricular pit

Preauricular pits are small, subtle indentations located anterior to the helix and superior to the tragus of the ear. These embryonic remnants are bilateral in up to 50% of cases and are most commonly found in Asian children. Microscopically, the preauricular pits are lined by normal squamous epithelium of the skin with all the adnexal structures, such as hair follicles, sebaceous glands and sweat glands. The wall of the pit may show cartilage of the ear. The lumen may contain keratinous material and inflammatory exudates.

Epidermal cyst

Epidermal cysts are the most common type of cutaneous cysts. presenting as elevated, firm, round, freely movable and slow growing intradermal cystic tumors mostly in hair-bearing areas on the scalp, neck, face and trunk. Most of the epidermal cysts derive from the infundibular part of the hair follicle. The epidermal cysts of the palms and soles originate from implantation of the epidermal squamous cells into the dermis. These cysts can be truly called epidermal inclusion cysts and trauma may be a factor causing the implantation of the epidermal cells. Microscopically, the epidermal cyst is located in the dermis and is lined by epidermis composed of keratinizing normal squamous cells with a granular layer. The lumen of the cyst contains flaky keratin arranged in laminated layers. As opposed to the preauricular cyst, adnexal structures are not present in the cyst wall.