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Sebaceous cyst (epidermoid cyst)

Sebaceous cyst (epidermoid cyst)

Sebaceous cyst (epidermoid cyst) are a common problem that affects people of all ages and both genders. What is the essence of atheroma disease?

Sebaceous cysts is not a tumor, but a cyst, that is, an atheroma is a "pouch" with a capsule and filled with thick yellowish masses, often having an unpleasant odor, due to blockage of the excretory duct of the gland by thickened discharge.

Sebaceous cysts develop on areas of the skin rich in sebaceous glands (scalp, face, back, anterior abdominal wall, scrotum).

Removal of the sebaceous gland capsule during the operation is necessary to prevent a possible recurrence of atheroma in this place.

 

Diagnostics of the sebaceous cysts

How does a sebaceous cyst manifest clinically? It can be located in many places of the body, more often on the face (cheek), scalp, torso, arms, on the scrotum. A sebaceous cyst is often multiple (sebaceous cystosis on the scalp).

On examination, the sebaceous cyst is a tumor-like formation of a round shape, soft consistency in size from 5 to 40 mm or more. The skin over the sebaceous cyst is usually unchanged, but in the case of a secondary infection (inflammation of the sebaceous cysts), it may have a reddish tint. A sebaceous cyst (epidermoid cyst) is mobile along with surrounding tissues, painless. The sebaceous cyst (epidermoid cyst) may remain small for many years or grow larger.

Sebaceous cysts and lipomas are very similar in appearance. To distinguish a sebaceous cyst from a lipoma can only be a doctor by indirect evidence. So, a lipoma, as a rule, is located in places of accumulation of subcutaneous fatty tissue, and sebaceous cyst - in places of the greatest accumulation of sebaceous glands; also, on close examination, sebaceous cysts have traces of an excretory duct - a blocked sebaceous gland. To the touch, these formations (sebaceous cysts and lipomas) are of a similar consistency, but while the sebaceous cyst is part of the skin, a lipoma is a subcutaneous formation that does not adhere to the skin surface.

Sometimes sebaceous cyst communicates with the surface of the skin through a small opening through which sebaceous cyst masses can be separated. Often, sebaceous cysts fester, resulting in inflammation followed by an abscess of the surrounding soft tissue. Also, sebaceous cysts may rupture into the subcutaneous tissue. If the sebaceous cyst is small and does not bother the patient, then it may not be removed. In other cases of sebaceous cysts, surgical treatment (operation) is indicated.

Removal of sebaceous cysts is an outpatient procedure. Sebaceous cysts are removed under local anesthesia with a 1-2% solution of novocaine or lidocaine.

 

Surgical treatment of sebaceous cysts

Removal of sebaceous cyst, method # 1

The incision is made at the site of the greatest bulging of the sebaceous cysts on the skin. The contents of the sebaceous cysts are squeezed onto a napkin. After that, the capsule of the cyst is grasped with two clamps and removed or the cavity of the cyst is scraped out with a sharp spoon.

Schematic representation of sebaceous cysts and sebaceous cysts capsules in the skin incision before surgery to remove it.

 

Removal of sebaceous cyst, method # 2

Carefully dissect the skin, being careful not to damage the capsule of the sebaceous cyst. The skin is removed from the sebaceous cysts, after which, pressing the edges of the wound with fingers, the sebaceous cyst is exfoliated.

Stage of the operation: anesthesia of the skin before the incision around the sebaceous cysts with novocaine or lidocaine.

 

Removal of sebaceous cyst, method # 3

This method is used most often. First, two bordering incisions are made over the sebaceous cyst, which should cover the opening of the cyst. The edges of the skin incision are grasped with clamps and, gently pulling on them, bring the branches of curved scissors under the sebaceous cyst. By spreading and closing the scissors, the sebaceous cyst is exfoliated from the surrounding tissue. Bleeding with this method of surgery to remove sebaceous cysts is usually minor.

Operation stage: removal of the contents of non-inflamed sebaceous cysts and the capsule of the sebaceous cyst, followed by the application of a skin suture.

After removal of the sebaceous cysts, separate absorbable sutures are applied to the subcutaneous tissue. After the operation to remove sebaceous cysts, vertical mattress sutures are placed on the skin with a thin atraumatic thread to prevent the wound edges from being screwed in. The sutures after the operation to remove the sebaceous cysts are removed after 7 days.