Generality
The sebaceous cyst is a subcutaneous neoformation of a benign nature, generally roundish.
The incision of this formation typically reveals a content of a cheesy appearance, often with a fetid odor, formed by epithelial debris and fatty material.
The sebaceous cyst appears as a slow-growing mass, detected on the skin plane, of a semi-solid consistency. This cystic formation is indolent, except in cases of infection.
Sebaceous cysts are frequently observed on the scalp, ears, face and back. The dimensions of these lesions are quite variable and sometimes they can reach 5-6 cm in diameter.
The treatment involves the drainage and surgical excision of the entire cyst, including the relative capsule, to prevent possible relapses.
Causes and risk factors
The sebaceous cyst is a collection of keratin, follicular or sebaceous material, which appears as a roundish subcutaneous mass.
The sebaceous cyst is formed following an occlusion of a sebaceous gland or its duct (that is, the channel that allows the passage of the relative products). If these structures become blocked or damaged, the gland can no longer dispose of the secretion of keratin, sebum and dead cells, which continues to occur. As a result, this material flows into the cyst and solidifies.
The occlusion of a sebaceous gland usually occurs due to trauma in the affected area . A scratch, a surgical wound or a skin condition (such as acne) can therefore promote the development of a cyst.
Stress, alcohol and tobacco abuse and the use of certain cosmetics also appear to play a role in the onset of these lesions.
Other factors that may favor the onset of a sebaceous cyst may include some genetic disorders, such as Gardner's syndrome or basal cell nevus syndrome.
Signs and symptoms
The sebaceous cyst appears as a roundish bulge, comparable to a small bump, easily visible under the skin . Growth is slowly progressive; the size of this new formation may vary from a few millimeters to 5-6 centimeters in diameter.
On palpation, the cystic mass is semi-solid, globular and mobile. This type of cyst rarely causes pain, but can cause discomfort if it occurs in more delicate areas of the body, such as the scalp or groin.
The large sebaceous cysts located on the face and neck can also cause a feeling of pressure, as well as being quite unpleasant from an aesthetic point of view.
Warning! Touching or squeezing a sebaceous cyst can cause it to leak out of its contents and increase the risk of infection. In this case, the area involved may turn red and be sore.
Location
Sebaceous cysts are observed mainly in the scalp, ears, neck, back and upper arms. However, these lesions can develop in every area of the body, with the exception of the sole of the foot and the palm of the hand.
In males, these cystic formations tend to appear quite frequently even at the level of the scrotal sac and thorax.
Possible complications
If the sebaceous cyst is ruptured, secondary bacterial infection can occur, resulting in a rapidly expanding abscess collection . This complication is associated with pain, redness and suppuration (formation of purulent material). Sometimes, its contents can be released outside, a whitish or greyish-white material, rather dense and smelly.
A large cyst tends to recur frequently, unless the cyst wall is completely removed.
Diagnosis
The sebaceous cyst is generally diagnosed with a simple physical examination, as the appearance of this lesion is easily recognizable by inspection and palpation .
If unusual signs are present, however, the doctor may indicate further tests to analyze the contents inside the cyst and to rule out other more serious diseases.
These investigations may include:
- Computed tomography;
- Ultrasound examination;
- Biopsy.
Treatment
Sebaceous cysts can be treated with oral medications or topical solutions, such as cortisone or antibiotic creams.
However, if the sebaceous cyst grows in volume or affects its aesthetic appearance, it is advisable to remove it surgically. The intervention involves drainage and excision of the mass with complete removal of the cystic wall .
In case of rupture of the cyst or suppuration, it is necessary to proceed with the timely incision of the lesion, then a drainage gauze is introduced which is removed after 2-3 days.
After treatment, oral antibiotics such as cloxacillin and erythromycin may be prescribed to prevent further complications in the affected area, while the sutured surgical wound remains covered and sterile for approximately 7-10 days.
