sebaceous cyst
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Sebaceous cyst:- Examination, diagnosis and treatment
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sebaceous cyst
- 2. • Sebaceous glands • Glands in the skin that secrete a lubricating substance called sebum. • Sebaceous glands either open into hair follicles or discharge directly on to the skin surface. • They are most numerous on the scalp, face, and anus and are absent from the palms and soles of the feet. • Sebum production is partly controlled by androgen hormones.
- 3. Sebaceous Cyst • Cyst of the sebaceous gland due to blockage of the duct of this gland. • The gland becomes distended by its own secretion(sebum). • Sebum is thick paste like yellowish, white, cheesy, pultaceous material.
- 4. Clinical features • It is commonly seen in young adults, though no age is exempt. • It may occur anywhere in the body except palm and sole, though it is commonly seen in the scalp, face and scrotum. • It may be single or multiple.
- 5. Clinical presentation • Patients presents with complain of swelling. • Almost always there is a black spot on the swelling, which is the obstructed opening and is called punctum. • This swellingis fixed to the skin but is quite movable over the deeper structures. • Sebum can be squeezed out from this cyst through the punctum. • Sometimes punctum is not visible.
- 6. Examination • It is smooth and of round shape whose margin yields to the palpating finger. • Overlying skin cannot be pinched. • Fluctuation test is always present. • Transillumination test is always negative. • Painless unless inflamed.
- 7. Management • (A) Sebaceous cyst (1.5 to 2 cm). • (B) Inject 1 mL of local anaesthetic over the top of the cyst to form a wheal. • (C) Incise with a No. 11 blade directly into the cyst. • (D) Express the contents of the cyst. • (E) Sebaceous material. • (F) Grasp the sac with haemostats and tease it free with gentle lateral pressure and a rocking motion. • (G) Sebaceous material and appearance of wound after removal. No closure is needed for a small incision. • Surgical Removal(excision) only.
- 8. Complications • Infection when the cyst becomes enlarged and painful. • Rupture and sinus formation. • Ulceration. • Calcification. • Carcinomatous changes. • Sebaceous horn