Infected Epidermal Inclusion Cyst (Sebaceous Cyst) Of The Ear

Epidermal Cyst Of Ear

Case 1: Infected Epidermal Inclusion Cyst (Sebaceous Cyst) Behind The Ear

Infected Epidermal Inclusion Cyst (Sebaceous Cyst) Behind The Ear

The epidermal inclusion cyst is a benign cyst filled with keratin fibers and its wall has almost the same characteristics as the epidermis. It is often seen in the skin and tends to slowly grow into deeper epidermis sections and cause cystic expansion.

Epidermoid cyst or epidermal inclusion cyst in the dermoid cyst subgroup is an ectodermal lesion that is limited to simple squamous epithelium and does not contain any additional structure. Teratoid cyst, another form, is a mass that is limited to various epithelial structures including stratified squamous and ciliary respiratory epithelium and contains components of ectodermal, endodermal and / or mesodermal origin

Epidermal inclusion cyst terminology

Technically for epidermal inclusion cyst (epidermal cyst), although a different entity, they are sometimes referred to as sebaceous cysts. The term sebaceous cyst indicates that the lesion originates from the sebaceous glands, which is not true, and the term epidermal inclusion cyst is more suitable to defining.

Why epidermal cyst occur?

Etiology of epidermal inclusion cysts

Epidermal cysts are cystic masses surrounded by keratinized squamous epithelium and filled with keratin debris. They are true cystic formations that can be seen in any part of the body. Clinically, it presents as a painless, slowly growing, well-circumscribed mass (1-2-5). Epidermal cysts develop as a result of implantation of superficial epidermal tissue into dermis or subcutaneous tissue after trauma or surgical procedure.

Case 2: Infected Epidermal Inclusion Cyst (Sebaceous Cyst) Earlobe

Epidermal Inclusion Cyst of Ear

Epidermal cysts are the most common palms and fingers in the body, but they are true cystic formations that can be seen in any part of the body. Only 7% of epidermal cysts are located in the head and neck region. Acquired epidermoid cysts occur as a result of surgical trauma by implanting superficial epidermal tissue into the dermis or subcutaneous tissue. Tympanomastoid surgery, stapedectomy, endaural incision, ventilation tube application. Ear procedures such as these have an important role in the development of epidermal cysts.

Most often in young and middle age men and women equal is seen frequently. Clinically, it presents as a painless, slow-growing, well-circumscribed mass. Slow growth is the rule. Symptoms from trauma to 6 months to 20 years may occur later. Malignant degeneration is very rare. Severe pain due to ruptured cyst and scar tissue may occur.

Diagnosis of epidermal inclusion cyst

Although the definitive diagnosis is made histopathologically, epidermal inclusion cysts are considered in the case of clinically recurrent, painful, tender and soft cystic areas of superficially located cysts. It can also be used for imaging in other regions of the body and for differential diagnosis.

Differential diagnosis of epidermal inclusion cyst

General imaging differential considerations include:
  • ganglion cyst
  • neurogenic tumors
  • nodular fasciitis
  • myxoid tumors

Symptoms of epidermal inclusion cyst

In general, the main symptom of epidermal inclusion cysts in the head and neck region and superficially located is the presence of locally recurring infected cysts and occasional growth and drainage of the cysts. Acute painful growth in cysts may occur especially when simple cysts are attempted to explode.

Treatment of epidermal inclusion cysts

Complete surgical excision

The definitive treatment for epidermal inclusion cysts is complete surgical excision. Drainage, oral antibiotics, warm application, administration of antibiotic-containing pomade or skin antisepics are generally not permanent treatment.

Recommendations for patients

If signs of infection (pain, swelling, redness and a feeling of warmth) occur, see your doctor immediately for appropriate medical attention. This is a very common medical procedure and there is nothing to worry about; however, if you ignore the infected cyst, it may become septic, in which case you can consult an ent doctor or skin care specialist.

You might want to see a doctor even if the cyst doesn't look infected. The doctor makes a tiny incision, and you get rid of the cyst in a minute or two. After the cyst is removed, 1-2 stitches may be required.

Never blast the cyst on its own

Cysts of this type disappear from themselves; If you try to explode, you increase the risk of infection even further and scars that may never go away. If you succumb to the need to explode and the cyst bothers you, get a doctor. If the cyst heals during the healing process or accidentally explodes and there is an opening in the skin, wash the area thoroughly with a non-irritating soap and running water.

You should avoid applying cosmetic products or skin care products to the cyst area

You should avoid applying cosmetic products or skin care products to the cyst site. Doing so may cause further irritation or infection.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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