Epidermoid cyst
Presentation
- Occur anywhere on the body in areas with relatively little hair
- Size varies from a few millimetres to 2cm
- Multiple cysts may occur
- Often associated with telangiectasia
- Usually asymptomatic, but may be painful if secondary infection occurs
- May discharge cheesy sebum and keratin
- Occur after implantation of the epidermis into the dermis because of trauma, such as piercing
Management
- May resolve spontaneously
- Treatment of choice is surgical excision
Meibomian cyst
Presentation
- Also known as chalazion or tarsal cyst
- Vary in size; 2-8mm in diameter
- Multiple cysts may occur, affecting both eyelids
- More common on upper eyelid
- Secondary infection may occur
- Arise from meibomian glands
- Often acute, but may persist and become chronic swellings
- More common in patients with blepharitis or eczema
Management
- Initially no treatment is advised
- Usually last two to six months without treatment
- Hot compresses can be helpful
- Surgical incision under local anaesthetic may be required
- May recur, but most will not
Digital myxoid cyst
Presentation
- Occur on finger ends
- Result of degeneration in connective tissue
- May connect with the underlying joint
- Smooth surface and varied sizes
- When overlying nail, may produce a groove as nail grows
- Contain jelly-like, sticky fluid
- Often associated with underlying osteoarthritis
Management
- Treatment not always required
- Pressure may lead to rupture
- Aspiration can be undertaken
- Treatments include cryotherapy
- In recurrent cases, surgical excision can be undertaken
Trichilemmal cyst
Presentation
- Also known as pilar cyst
- Most (70%) associated with other cysts, but 30% are solitary
- More common on hair-bearing areas, especially scalp (90%)
- Derived from outer root sheath of hair follicle
- Smooth surface and mobile
- Filled with keratin
- There may be a family history
- Malignant transformation may occur, but is extremely rare
Management
- Treatment not always required
- If required, surgical excision can be undertaken
- Failure to remove cyst capsule increases risk of recurrence
Dr Stollery is a GP in Leicestershire
