Posted by: admin on: March 12, 2012
The sebaceous cysts, epidermoid cysts, also called by some, is a subcutaneous lesion that looks like a small bump visible under the skin or scalp. Very rare in children and uncommon in women, it is usually due to a solidification of the secretion of a sebaceous gland that occludendosi can no longer waste by the production, so the hair follicle swells and gives rise to this lesion. It ‘possible that tobacco, alcohol, anxiety, stress and some cosmetics concausale have a role in the genesis of these cysts. The growth is mostly slow and not very annoying and the dimensions may vary from a few millimeters up to even to 5/6 centimeters in diameter. The appearance is that of a ball with an external capsule; inside contains a mixture of air, liquid, sebum or other substances semi-solid, whitish in color for the most part, particularly malodorous and creamy texture, or caseous, fairly typical. Touch or squeeze out a sebaceous cyst might cause the exterior of your content and increases the risk of infection.
Sebaceous cysts may be found a little ‘everywhere, even in large numbers in the same patient under the scalp, in the region of the neck, shoulders and back, but also under the armpits, in the gluteal region, the scrotal sac, the genitals, and more rarely in the mammary region, abdomen and face. The main symptom that usually causes the patient to contact the physician is usually a small lump under the skin soft, often painless, but it may periodically become red, infected, causing temporary pain and even fever. Another typical sign is the possible release outside of its contents, the above described material whitish or greyish white, quite thick and the typical rancid and nauseating. It may even happen that the patient does not notice the presence of these growths until for the first time not undergo an inflammatory process, causing redness and increased sensitivity and temperature of the region concerned.
In most cases, the surgeon, or at least the doctor who has sufficient experience, is able to identify a sebaceous cyst just thanks to the visit: that’s because their appearance is easily recognized by inspection and palpation. An ultrasound can help, but is mostly reserved for the rare case really doubt. Some surgeons sometimes recommend a biopsy: Although this procedure may be useful to rule out more serious diagnosis, I personally almost always not advisable, at least where experience suggests that the Operator is in any case of something that did before or then should be removed. Finally, especially if the cyst is localized in specific regions of the body, it is sometimes necessary to distinguish genital herpes in a form, to a careless eye, may appear somewhat similar.
Sebaceous cysts are not dangerous and in some cases it may even happen that reabsorb individually. Other times can be successfully treated with simple remedies: Applying skin creams, medications by mouth. If you are a small presence of inflammation, the doctor may prescribe antibiotics or corticosteroids to reduce swelling. If the cyst does not respond to therapy, increases in volume and / or affect the aesthetic is best to remove it surgically.
If the skin is reddened, and the cyst is inflamed, your doctor will advise you to postpone the surgery, however, administration of antibiotics and / or inflammation in the capsule is expected to return to a consistency that it can be assumed to be fully removed. At this stage it is not advisable to touch the cysts because this would worsen the inflammation itself, it is also inappropriate to affect the skin for groped to drain the contents, because such a maneuver would alter the integrity of the capsule, however, by providing the patient with relapse. If the physician is involved in a stadium where the inflammation has gone so far as to make too fine layer overlying skin, and therefore it is believed that the spontaneous perforation is imminent and irreversible, then it may be preferable to make a small incision which, while not definitively solving the problem, however, allows to overcome the critical phase of the abscess and also to leave a scar less visible on the skin.
The definitive surgery, in any case, can be accomplished for the most under local anesthesia; consists of a small incision from which it will need to remove the entire cyst, trying to understand therefore also the relative capsule: this procedure while shielding from possible recurrence. The aspiration of the contents by needle, still practiced by some, can do without anesthesia, but does not guarantee certain results about its ultimate disappearance.
It ‘s preferable that the surgical wound sutured remains covered and sterile for 7-10 days after surgery, requiring only periodic dressings, while a preventive antibiotic therapy is commonly prescribed for a period of little less. To prevent the permanent scars take a bit ugly reddish color is always advisable to protect it from sunlight during the first 6-12 months.
Complications and recurrences
A sebaceous cyst can become infected and lead to an abscess: local application of heat (hot water bottle) can accelerate its maturation, and is indicated only when the physician believes that this process, despite therapy, however, is irreversible. Recurrences are however possible, especially when in the course of action the capsule is not removed completely: a fragment thereof can be in fact sometimes responsible for the formation of a new cysts. For this reason you should avoid operating during inflammation, when the fragility of the capsule increases the chances that you can not remove it all.