Inflamed Epidermal Inclusion Cyst

, Corinna Eleni Psomadakis2 and Bobby Buka3



(1)
Department of Family Medicine, Mount Sinai School of Medicine Attending Mount Sinai Doctors/Beth Israel Medical Group-Williamsburg, Brooklyn, NY, USA

(2)
School of Medicine Imperial College London, London, UK

(3)
Department of Dermatology, Mount Sinai School of Medicine, New York, NY, USA

 



Keywords
Epidermal inclusion cystEpidermoid cystCystSebaceous cystTumorGrowthNeoplasmInflamedInflammationSubcutaneousExcisionIntralesional steroidCorticosteroidInjectionIncision and drainagePunch excision




A321378_1_En_28_Fig1_HTML.jpg


Fig. 28.1
These lesions are often misdiagnosed as infectious, but the inflammation seen here is a foreign body reaction to keratin


Primary Care Visit Report


A 36-year-old female with no past medical history presented with a bump on her right shoulder, which had been present and unchanged for years. However, a few days prior to this visit, it became red, tender, and painful . She felt well otherwise.

Vitals were normal. On exam, on her right posterior shoulder, there was a 1 cm × 1 cm erythematous papule that was tender to palpation and indurated.

The diagnosis was uncertain, and the patient was referred to dermatology for further evaluation.


Discussion from Dermatology Clinic



Differential Dx






  • Epidermal inclusion cyst (EIC)


  • Lipoma


  • Pilomatricoma


  • Abscess


Favored Dx


Patient history is suggestive of a ruptured and inflamed EIC .


Overview


Epidermal inclusion cysts (EIC), also called epidermoid cysts , are epithelial-lined cysts filled with keratin and lipid-rich debris. The term sebaceous cyst is also commonly used; however, it is inaccurate, as the cysts neither involve sebaceous glands nor contain sebum.

EICs can occur at any age and on any part of the body, although they are more likely to appear in adults [1]. They frequently appear on the chest, back, face, neck, and scalp. The most common cause is occlusion of the pilosebaceous unit. They may also be caused by trauma, when penetration by an object may cause implantation of epidermal cells into deeper tissue of the dermis, or by congenital sequestration of a collection of epidermal cells. Hereditary diseases such as Gardner syndrome, pachyonychia congenita, and Gorlin syndrome all feature multiple EICs.

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Jun 29, 2017 | Posted by in Uncategorized | Comments Off on Inflamed Epidermal Inclusion Cyst
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