Tumors of the Skin

Chapter 662 Tumors of the Skin




See also Chapters 499 and 643.



Epidermal Inclusion Cyst (Epidermoid Cyst)


Epidermoid cysts are the nodules most commonly seen in children. Such a cyst is a sharply circumscribed, dome-shaped, firm, freely movable, skin-colored nodule (see Fig. 662-1 on the Nelson Textbook of Pediatrics website at www.expertconsult.com image), often with a central dimple or punctum that is a plugged, dilated pore of a pilosebaceous follicle. Epidermoid cysts form most frequently on the face, neck, chest, or upper back and may periodically become inflamed and infected secondarily, particularly in association with acne vulgaris. The cyst wall may also rupture and induce an inflammatory reaction in the dermis. The wall of the cyst is derived from the follicular infundibulum. A mass of layered keratinized material that may have a cheesy consistency fills the cavity. Epidermoid cysts may arise from occlusion of pilosebaceous follicles, from implantation of epidermal cells into the dermis as a result of an injury that penetrates the epidermis, and from rests of epidermal cells. Multiple epidermoid cysts may be present in Gardner syndrome and the nevoid basal cell carcinoma syndrome. Excision of the cysts with removal of the entire sac and its contents is indicated, particularly if the cyst becomes recurrently infected. A fluctuant, infected cyst should be treated with an antibiotic effective against Staphylococcus aureus. After the inflammation subsides, the cyst should be removed.









Jun 18, 2016 | Posted by in PEDIATRICS | Comments Off on Tumors of the Skin
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