Abstract

Epidermal inclusion cysts are common benign cutaneous cysts which arise from hair follicles. These cysts usually present as asymptomatic, small, smooth, firm, round, slow growing swellings on hair bearing areas such as scalp, face, neck and trunk. Epidermal inclusion cysts are easily diagnosed by their clinical features. However, trichilemmal cyst, dermoid cyst, neurofibroma, hemangioma, lipoma and liposarcoma should also be kept in mind in differential diagnosis of cutaneous cystic lesions. As malignant transformation of epidermal inclusion cysts has been reported, histopathological evaluation of epidermal inclusion cysts is mandatory in order to rule out malignancy. Moreover, giant epidermal inclusion cysts with ulceration, rapid growth, resistance to treatment, recurrence and fistula drainage may have malignant potential. Therefore, epidermal cysts should be surgically removed. There are several different types of surgical techniques to remove cutaneous cysts. A proper surgical technique should facilitate the complete removal of the cyst wall to prevent recurrence. In addition, it should provide minimal scarring and a low wound infection rate. Epidermal inclusion cysts can be easily removed surgically with squeeze technique. In this technique, the cyst is squeezed out through a small incision using both index fingers. Thus, the cyst is not ruptured. The squeeze technique allows the cyst capsule to remain intact. Therefore, the risk of wound infection, recurrence and scar formation is minimized. Hereby, we present a 48-year-old male with multiple epidermal inclusion cysts on the scalp treated surgically with squeeze technique.

Highlights

  • Epidermal inclusion cysts are common cutaneous and subcutaneous cysts which usually arise on head, neck and trunk as solitary slow growing masses (Makhija, 2014; Baek, Kim, Jung, Sohn & Kwon, 2011)

  • We present a 48-year-old male with multiple epidermal inclusion cysts on the scalp treated surgically with squeeze technique

  • Epidermal cysts are usually treated by surgical excision, removal of these cysts through a hole made by an erbium:yttrium aluminum garnet (Er:YAG) laser or CO2 laser may be the choice of treatment in order to achieve less scarring (Feng & Ma, 2015; Song, Burm, Yang & Kang, 2014)

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Summary

INTRODUCTION

Epidermal inclusion cysts are common cutaneous and subcutaneous cysts which usually arise on head, neck and trunk as solitary slow growing masses (Makhija, 2014; Baek, Kim, Jung, Sohn & Kwon, 2011) These lesions usually occur in adults between the ages of 30 and 40 (Mote & Shukla, 2011). The diagnosis of an epidermal inclusion cyst can be made by its clinical features, ultrasonography, computed tomography and magnetic resonance imaging may be helpful in suspicious lesions (Hwang, Yim, Kwon & Jung, 2008) Complications such as infection, inflammation and hemorrhage may lead to spontaneous rupture of the cyst (Mote & Shukla, 2011).

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