Follicular Hybrid Cyst of the Eyelid

A 51-year-old man had a lesion of the right lower eyelid (Fig 1), present for a year, surgically removed. Histopathology revealed a rare pilosebaceous hybrid cyst lined by 2 distinctive cell types: a bilayer epithelium of ductal origin (Fig 2, bold arrows) and keratinized stratified epithelium of infundibular origin (Fig 2, thin arrows). Most pilosebaceous cysts, in contrast, are composed of components from a single portion of the pilosebaceous complex. The different types of cutaneous cysts are shown in the diagram (Fig 3).