sebaceous cyst

Sebaceous cyst:-
Examination, diagnosis and treatment

1. Sebaceous Cyst

2. Sebaceous glands Glands in the skin that secrete a lubricating substance called sebum. Sebaceous glands either open into hair follicles or discharge directly on to the skin surface. They are most numerous on the scalp, face, and anus and are absent from the palms and soles of the feet. Sebum production is partly controlled by androgen hormones.

3. Sebaceous Cyst Cyst of the sebaceous gland due to blockage of the duct of this gland. The gland becomes distended by its own secretion(sebum). Sebum is thick paste like yellowish, white, cheesy, pultaceous material.

4. Clinical features It is commonly seen in young adults, though no age is exempt. It may occur anywhere in the body except palm and sole , though it is commonly seen in the scalp, face and scrotum. It may be single or multiple.

5. Clinical presentation Patients presents with complain of swelling. Almost always there is a black spot on the swelling, which is the obstructed opening and is called punctum. This swellingis fixed to the skin but is quite movable over the deeper structures. Sebum can be squeezed out from this cyst through the punctum. Sometimes punctum is not visible.

6. Examination It is smooth and of round shape whose margin yields to the palpating finger. Overlying skin cannot be pinched. Fluctuation test is always present. Transillumination test is always negative. Painless unless inflamed.

7. Management (A) Sebaceous cyst (1.5 to 2 cm). (B) Inject 1 mL of local anaesthetic over the top of the cyst to form a wheal. (C) Incise with a No. 11 blade directly into the cyst. (D) Express the contents of the cyst. (E) Sebaceous material. (F) Grasp the sac with haemostats and tease it free with gentle lateral pressure and a rocking motion. (G) Sebaceous material and appearance of wound after removal. No closure is needed for a small incision. Surgical Removal(excision) only.

8. Complications Infection when the cyst becomes enlarged and painful. Rupture and sinus formation. Ulceration. Calcification. Carcinomatous changes. Sebaceous horn

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