Multiple Epidermal Cysts of the Scalp: Dermatosurgical Approach with Favourable Outcome!

Authors

  • Georgi Tchernev Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria; Onkoderma, Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
  • Ivanka Temelkova Medical Institute of Ministry of Interior (MVR) Department of Dermatology, Venereology and Dermatologic surgery , General Skobelev 79, 1606 Sofia; Onkoderma- Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606 Sofia
  • Irina Yungareva Medical Institute of Ministry of Interior (MVR) Department of Dermatology, Venereology and Dermatologic surgery, General Skobelev 79, 1606 Sofia, Bulgaria
  • Uwe Wollina Department of Dermatology and Allergology, Teaching Hospital Dresden, Academic Friedrichstrasse 41, 01067, Dresden, Germany

DOI:

https://doi.org/10.3889/oamjms.2019.257

Keywords:

Epidermal cyst, Malignancy, Surgery, Treatment, Recurrence

Abstract

BACKGROUND: Epidermal cysts are subcutaneous tissue formations that are most commonly located in the area of scalp, trunk and face. In addition to single ones, the cysts may also be multiple, located near each other. Although they are considered to be a cystic ectasia of the hair infundibulum and mainly affect hairy parts, they can also be seen in the area of palms and feet as a result of trauma. Rare extracutaneous localisations are also described in the medical literature, affecting the oral cavity, intraosseous, cerebrum and sublingual epidermoid cyst. Although the majority of epidermal cysts are benign, a malignant transformation may also occur in the direction of development of squamous cell carcinoma, basal cell carcinoma or Merkel cell carcinoma. Clinically, they are presented as benign lesions, and only histological examination may reveal their malignant potential. Therefore, their surgical removal and subsequent histology are of paramount importance for the elucidation of their origin.

CASE PRESENTATION: An 88-year old patient was hospitalized for surgical removal of two tumorous formations in the head area which have been available for many years. During the dermatological examination in the frontal and parietal area of the head, the presence of two oval pink cystic neoplasms, clinically suspected for epidermal cysts, was found. The lesion located in the frontal area was removed by elliptical excision. The resulting surgical defect was closed by undermining the wound edges and mobilisation of the released skin to the middle of the defect, as the latter being closed by single interrupted sutures. In the second surgical session, the lesion located in the parietal region of the head was also removed under local anaesthesia. A so-called island flap was performed in which the tumour formation was removed by oval excision followed by contouring a triangle in the distal direction and transposition of the undermined triangle to the oval surgical defect. The resulting defect was recovered by single interrupted sutures.

CONCLUSION: First-line treatment of epidermal cysts is surgical excision, and it is important to remove the cyst wall to minimise the risk of relapses and recurrence. Other treatment options include laser therapy with CO2, erbium-YAG laser or intralesional drainage injection of triamcinolone acetonide.

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Published

2019-05-13

How to Cite

1.
Tchernev G, Temelkova I, Yungareva I, Wollina U. Multiple Epidermal Cysts of the Scalp: Dermatosurgical Approach with Favourable Outcome!. Open Access Maced J Med Sci [Internet]. 2019 May 13 [cited 2024 Mar. 29];7(9):1509-11. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.257

Issue

Section

C- Case Reports

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