What is epidermoid cyst?
An epidermoid cyst is a benign, slow-growing intradermal or subcutaneous tumor, appearing as a closed capsule or sac-like structure underneath the skin.
These cysts contain semi solid, cheese-like material. They are usually caused by the trapped epidermal cells and keratin protein below the skin due to damage of skin or hair follicle. Normally they do not cause any symptoms and occur usually on face, trunk, neck, extremities, scrotum and scalp.
Though these lesions are benign and harmless, rare cases of transformation to malignancy have been reported. Basal cell carcinoma, Bowens disease and melanoma in Situ have developed from epidermoid cysts. These harmless lesions do not require treatment. If they cause a serious cosmetic problem to the patient or develop symptoms of inflammation, they can be removed surgically.
The epidermoid cysts are also known as epidermal inclusion cysts. They are sometimes wrongly called as as sebaceous cysts. True sebaceous cysts arise from sebaceous glands which secrete sebum to lubricate and moisturize the skin.
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Rather we can consider these sebaceous lesions as a type of epidermal nodules.
It is noteworthy that epidermal capsules may also appear on body parts devoid of sebaceous glands like lips and buccal mucosa. Milia (milk spots) with symptoms of very small superficial lesions is of exclusive epidermal origin.
What causes epidermoid cyst?
Epidermal nodules may arise due several causes. Basically they are caused by the presence of epidermal cells and their growth in dermal layer of the skin or other organs of the body. This may happen during the embryonic growth or caused by the trapped epidermal cells and keratin protein in the dermal layer of skin due to damage, surgery or piercing of skin . The source of downward incursion of the epidermis into the underlying dermis is mostly infundibulum of the hair follicle.
Crushing injuries, needle piercing and certain surgical procedures such as skin grafts, rhinoplasty, breast augmentation and liposuction have been found to cause epidermoid cysts. Human papillomavirus (HPV) is found to be a factor in the development of these cysts in palms and soles. In some cases HPV presence has been detected in these lesions from other areas of the body.
Congenital epidermal lesions of the anterior fontanelle, oral region and genital location are presumably caused during embryonic development. Certain familial syndromes like Gardner syndrome pachyonychia congenita and basal cell nevus syndrome are also found associated with these epidermal nodules. Favre-Racouchot syndrome is an offshoot of sun damage in elderly people characterized by symptoms of nodular cutaneous elastosis with cysts and comedones.
Symptoms of epidermoid cyst
These firm round nodules appear flesh-colored or yellowish.
Normally these lesions do not cause any symptoms. They are more common in men than women. Except for congenital or hereditary lesions, these nodules are found to arise in the middle age or later. Sometimes they may get infected and give rise to symptoms like inflammation and pain. Infected nodules may discharge foul-smelling pus and other contents. In some cases these lesions become inflamed without any infection, showing symptoms like tenderness and pain.
Treatment becomes necessary when when these nodules cause cosmetic problems, get infected, rupture, present in the area for constant friction or painful. Surgical excision of the entire epidermoid cyst including its wall will cure the condition.
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Reference:
1.Information from your family doctor. Minimal excision technique for removal of an epidermoid cyst. Am Fam Physician. 2002 Apr 1;65(7):1423-4.
2.2.G.Siva Prasad Reddy, N.V.S.Sekhar Reddy, G.V Reddy, Sriharsha K. Gaint Epidermoid Cyst of External Ear– A Rare Case Report. J Clin Diagn Res. Feb 2014; 8(2): 167–168.
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Image source:
1.http://en.wikipedia.org/wiki/File:Epidermal_Cyst_ear.JPG
Author: JonathanRR | License: CC BY-SA 3.0
Current topic in natural skin care: Causes and symptoms of epidermoid cyst.