SEBACEOUS CYST

INTRODUCTION:

ETIOLOGY:

• Forms due to defect in sebaceous gland. 
  • Sebaceous gland produces oil called “Sebum” to coat the hair & skin. 
• Cysts develop if gland/its duct is damaged or blocked. 
  • Usually occurs due to trauma.
  • Trauma may be scratch, surgical wound, or skin condition (acne). 
  • Trauma may have occurred months or weeks before cyst is noticed.
• Other causes:
  • Misshapen or deformed duct.
  • Damage to cells during surgery.
  • Genetic conditions, such as Gardner’s syndrome or basal cell nevus syndrome.

SYMPTOMS:

• Pain:
  • Small cysts – not painful. 
  • Large cysts – Uncomfortable to considerably painful. 
    • Large cysts on face & neck may cause pressure & pain.
• Cyst contents:
  • Facial cysts typically filled with white flakes of keratin (key element of skin & nails). 
  • Most are soft to touch.
• Considered unusual.
• Is possibly cancerous, if it has following characteristics:
• Larger diameter than 5 cms.
• Fast rate of reoccurrence after being removed.
• Signs of infection (Like redness, pain, or pus drainage).

DIAGNOSIS:

• CT scan – To identify best route for surgery & spot abnormalities.
• Ultrasounds – To identify contents inside cyst.
• Punch biopsy.

TREATMENT:

• Best treatment  – Ensure complete removal through surgery.
  • Conventional wide excision: Completely removes cyst residual with long scar.
  • Minimal excision: Causes minimal scarring yet has recurrence risk.
  • Laser with punch biopsy excision: the laser is used to make a small hole to drain cyst contents and the outer walls of the cyst are removed about a month later.

COMPLICATIONS:

• CHALAZION
• Cock’s peculiar tumour

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