MEHMET EREN YUKSEL: Surgical Removal Of The Epidermal Inclusion Cysts With Squeeze Technique: Case Report

SURGICAL REMOVAL OF THE EPIDERMAL INCLUSION CYSTS WITH SQUEEZE TECHNIQUE: CASE REPORT

Mehmet Eren Yuksel, Funda Tamer

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.

Keywords

Epidermal inclusion cyst, Squeeze technique, Surgery

Full Text:

PDF

References

Antón-Badiola, I., San Miguel-Fraile, P., Peteiro-Cancelo, A., & Ortiz-Rey, J. A. (2010). Squamous cell carcinoma arising on an epidermal inclusion cyst: a case presentation and review of the literature. Actas Dermosifiliogr, 101, 349-53.

Baek, S. O., Kim, S. W., Jung, S. N., Sohn, W. I., & Kwon, H. (2011). Giant epidermal inclusion facial cyst. J Craniofac Surg, 22, 1149-1151.

Durai, R. (2009). Squeeze eversion of small sebaceous cyst-novel technique to prevent rupture during excision. The Internet Journal of Surgery, 20.

Feng, C. J., & Ma, H. (2015). Treatment of epidermal cysts with erbium: YAG laser fenestration: an alternative to surgical intervention. Ann Plast Surg, 74, Suppl 2, S89-92.

Hayes, M. (Ed). (2014). Cysts and lipoma. In: Practical Skin Cancer Surgery, pp 223-232. Marrickville, Elsevier.

Horoz, U., Eryılmaz, T., Özakpınar, H. R., & Tellioğlu, A. T. (2012). Parmak pulpasında epidermal inklüzyon kisti: Geç fark edilen bir olgu. Turk Plast Surg, 20, 43-44.

Hwang, D. Y., Yim, Y. M., Kwon, H., & Jung, S. N. (2008). Multiple huge epidermal inclusion cysts mistaken as neurofibromatosis. J Craniofac Surg, 19, 1683-1686.

Ikizoglu, G., Kaya, T. I., Tursen, U., & Baz, K. (2003). The use of the freer dissector for the removal of trichilemmal cysts. Int J Dermatol, 42, 405-407.

Makhija, M. (2014). Epidermal inclusion cyst embedded in a recurrent benign fibrous histiocytoma. Indian J Dermatol, 59, 490-491.

Mehrabi, D., Leonhardt, J. M., & Brodell, R. T. (2002). Removal of keratinous and pilar cysts with the punch incision technique: analysis of surgical outcomes. Dermatol Surg, 28, 673-677.

Mote, D. G., & Shukla, A. A. (2011). Epidermal inclusion cyst masquerading breast lump. Indian J Surg, 73, 458-459.

Ramakrishnan, K. (2002). Techniques and tips for lipoma excision. Am Fam Physician, 66, 1405-1406.

Shalom, A., Persitz, A., & Westreich, M. (2012). A surgical technique for excision of epidermal cysts. Dermatol Surg, 38, 1856-1858.

Song, S. W., Burm, J. S., Yang, W. Y., & Kang , S. Y. (2014). Minimally invasive excision of epidermal cysts through a small hole made by a CO2 laser. Arch Plast Surg, 41, 85-88.

DOI: http://dx.doi.org/10.12955/emhpj.v8i2.669

Print ISSN 1804-5804, Online ISSN 1804-9702