Epidermoid cyst

Synonym(s)

Epidermal cyst; epidermal inclusion cyst; wen; atheroma; steatoma; sebaceous cyst

Definition

Cyst with a stratified squamous lining, which produces keratin

Clinical manifestation

Polymorphic, verrucous or flat-topped papules resembling flat warts; macules and reddish-brown plaques with slightly scaly surfaces and irregular borders; localized mostly on sun-exposed regions, palms, soles, in the axillae, and on external genitalia; mucous membranes rarely affected; malignant tumors typically appears during the fourth and fifth decades of life

Differential diagnosis

Verruca plana; squamous cell carcinoma; tinea versicolor; trichoepithelioma; basal cell carcinoma; papular mucinosis; solar elastosis

Pathogenesis

Derived from follicular infundibulum; often occurring at site of previous trauma (inflammatory acne, etc.)

Clinical manifestation

White or pale yellow, deep dermal or subcutaneous, medium-firm papule or nodule, often with a central pore; cheesy, foul-smelling material sometimes exuded with lateral pressure

Differential diagnosis

Lipoma; trichilemmoma; steatocystoma multiplex; granuloma annulare; sarcoido-sis; lymphocytic infiltrates; insect bite reaction; acquired perforating disease; metastasis

212 Epidermolysis bullosa

Therapy

Simple excision by sharp dissection*; elliptical excision; marsupialization of large lesions; inflamed lesion: incision and drainage of purulent material; triamcinolone (35 mg per ml) injected intralesionally

References

Pariser RJ (1998) Benign neoplasms of the skin. Medical Clinics of North America 82(6)11285-1307

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