sebaceous cyst

Image:Sebaceous cyst.jpg

The scalp, ears, back, face, and upper arm, are common sites of sebaceous cysts, though they may occur anywhere on the body except the palms of the hands and soles of the feet.{{Cite web|title=Sebaceous Cysts: Treatment & Cause|url=https://my.clevelandclinic.org/health/diseases/14165-sebaceous-cysts|access-date=2022-02-05|website=Cleveland Clinic}} They are more common in hairier areas, where in cases of long duration they could result in hair loss on the skin surface immediately above the cyst. They are smooth to the touch, vary in size, and are generally round in shape.

They are generally mobile masses that can consist of:

• Fibrous tissues and fluids
• A fatty (keratinous) substance that resembles cottage cheese, in which case the cyst may be called "keratin cyst" – this material has a characteristic "cheesy" or foot odor smell
• A somewhat viscous, serosanguineous fluid (containing purulent and bloody material)

The nature of the contents of a sebaceous cyst, and of its surrounding capsule, differs depending on whether the cyst has ever been infected.

With surgery, a cyst can usually be excised in its entirety. Poor surgical technique, or previous infection leading to scarring and tethering of the cyst to the surrounding tissue, may lead to rupture during excision and removal. A completely removed cyst will not recur, though if the patient has a predisposition to cyst formation, further cysts may develop in the same general area.

Cysts may be related to high levels of testosterone, hence may be more frequent in users of anabolic steroids.{{cite journal|last1=Scott|first1=MJ|last2=Scott|first2=AM|date=1992|title=Effects of anabolic-androgenic steroids on the pilosebaceous unit|journal=Cutis|volume=50|issue=2|pages=113–116|pmid=1387354}}

Hereditary causes of sebaceous cysts include Gardner's syndrome and basal cell nevus syndrome.{{Citation needed|date=July 2025}}

{{main|Epidermoid cyst}}

{{main|Pilar cyst}}

About 90% of pilar cysts occur on the scalp, with the remaining sometimes occurring on the face, trunk, and extremities.{{rp|1477}} Pilar cysts are significantly more common in females, and a tendency to develop these cysts is often inherited in an autosomal dominant pattern.{{rp|1477}} In most cases, multiple pilar cysts appear at once.{{cite book|editor=Barnes L|title=Surgical pathology of the head and neck|year=2008|publisher=Informa Healthcare|location=New York|isbn=978-0849390234|edition=3rd}}{{rp|1477}}

{{More citations needed section|date=September 2007}}

Sebaceous cysts generally do not require medical treatment. However, if they continue to grow, they may become unsightly, painful, and/or infected.

Surgical excision of a sebaceous cyst is a simple procedure to completely remove the sac and its contents,{{cite journal |vauthors=Klin B, Ashkenazi H |title=Sebaceous cyst excision with minimal surgery |journal=American Family Physician |volume=41 |issue=6 |pages=1746–8 |year=1990 |pmid=2349906 }} although it should be performed when inflammation is minimal.{{cite journal|author=Zuber TJ|year=2002|title=Minimal excision technique for epidermoid (sebaceous) cysts|url=http://www.aafp.org/afp/20020401/1409.html|journal=Am Fam Physician|volume=65|issue=7|pages=1409–12, 1417–8, 1420|pmid=11996426}}

File:Sebaceous Cyst.jpg

Three general approaches are used - traditional wide excision, minimal excision, and punch biopsy excision.{{cite journal |vauthors=Moore RB, Fagan EB, Hulkower S, Skolnik DC, O'Sullivan G |title=Clinical inquiries. What's the best treatment for sebaceous cysts? |journal=The Journal of Family Practice |volume=56 |issue=4 |pages=315–6 |year=2007 |pmid=17403333 }}

The typical outpatient surgical procedure for cyst removal is to numb the area around the cyst with a local anaesthetic, then to use a scalpel to open the lesion with either a single cut down the center of the swelling, or an oval cut on both sides of the center point. If the cyst is small, it may be lanced, instead. The person performing the surgery will squeeze out the contents of the cyst, then use blunt-headed scissors or another instrument to hold the incision wide open while using fingers or forceps to try to remove the cyst wall intact. If the cyst wall can be removed in one piece, the "cure rate" is 100%. If, however, it is fragmented and cannot be entirely recovered, the operator may use curettage (scraping) to remove the remaining exposed fragments, then burn them with an electrocauterization tool, in an effort to destroy them in place. In such cases, the cyst may recur. In either case, the incision is then disinfected, and if necessary, the skin is stitched back together over it. A scar will most likely result.

An infected cyst may require oral antibiotics or other treatment before or after excision. If pus has already formed, then incision and drainage should be done along with avulsion of the cyst wall with proper antibiotics coverage.

An approach involving incision, rather than excision, has also been proposed.{{cite journal |author=Nakamura M |title=Treating a sebaceous cyst: an incisional technique |journal=Aesthetic Plastic Surgery |volume=25 |issue=1 |pages=52–6 |year=2001 |pmid=11322399 |doi=10.1007/s002660010095|s2cid=8354318 }}

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{{Medical resources

| DiseasesDB = 29388

| ICD10 = Epidermoid cyst {{ICD10|L|72|0|0|60}},
Pilar cyst {{ICD10|L|72|1|l|60}}

| ICD9 = {{ICD9|706.2}}

| ICDO =

| OMIM =

| MedlinePlus = 000842

| eMedicineSubj =

| eMedicineTopic =

| MeshID = D004814

| ICD10CM = {{ICD10CM|L72.3}}

}}

{{commons category|Sebaceous cysts}}

• [https://web.archive.org/web/20100408042923/www.umm.edu/ency/article/000842all.htm Overview] at University of Maryland Medical Center
• {{EMedicine|derm|860|Epidermal Inclusion Cyst}}

{{Disorders of skin appendages}}

{{Authority control}}

{{DEFAULTSORT:Sebaceous Cyst}}

Category:Epidermal nevi, neoplasms, and cysts