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July 1988

Blue Papules on the Chest

Arch Dermatol. 1988;124(7):1106a-1106b. doi:10.1001/archderm.1988.01670070095031

REPORT OF A CASE  A 33-year-old woman presented with a two-year history of asymptomatic lesions of the chest. There was no family history of similar lesions.Physical examination revealed multiple, nontender, firm, blue papules on the anterior aspect of the chest (Fig 1). Representative sections of the biopsy specimen are shown in Figs 2 and 3.What is your diagnosis?

DIAGNOSIS:  Eruptive vellus hair cysts.

DISCUSSION  Eruptive vellus hair cysts present clinically as discrete yellow to red-brown to blue papules. Sites of predilection are the anterior aspect of the chest and the extremities, but other areas may also be involved. Although there was no family history of similar lesions in our case, evidence has been reported suggesting a dominant inheritance pattern in some cases.1Histologic examination of the papules shows a middermal cyst containing keratinous material and multiple vellus hairs. The exact cause