Valeria Chavez

March 1, 2015

Case Study 1

Patient Introduction
A 50- year old male presented with a recurring sebaceous epidermoid cyst on his
scalp, that had been removed once prior to regrowth, however it had bursted before
being removed the first time, leading us to believe the entirety of the body may not have
been removed. He requested the removal of the cyst for aesthetic and preventative
reasons.
Pathophysiology and Etiology
Epidermoid cysts are a buildup of keratin and tissue below the skin and are not
true sebaceous cysts as they do not form from sebaceous glands as the name would
imply. However, the term can still be applied and be understood as such. They appear
as round, soft bumps and are filled with keratin, which if ruptured, can irritate the
surrounding tissue. They can arise from a clogged follicle or gland and can appear
anywhere on the body, excluding the palms and soles, but are most common on the
scalp, face, and lumbar region. They typically do not become cancerous, but theyre are
reported cases of epidermoid cysts developing into skin cancer. The biggest issues with
cysts are the potential of bursting, tenderness, inflammation, and cosmetic discomfort.
Anyone can develop a cysts, but those with a history of acne, skin injuries, or a family
history of basal cell nevus syndrome, are predisposed to develop cysts.
Signs and Symptoms
Cysts are characterized by the appearance of a round bump that moves when
pushed that has been growing slowly and may have drained a yellowish, foul-smelling,
thick material. It may be inflamed and/or tender due to rupturing or infection, or have a
blackhead in the center.
Diagnosis
Sebaceous cysts are easily diagnosed by being viewed by a dermatologist. A
biopsy may be taken, but is usually not necessary.
Medical/ Surgical Treatment
If the cyst is small and does not bother the patient, then it can be ignored and will
probably go away on its own within a few months. Injection and drainage, putting antiinflammatory medicine into the cyst or cutting into the cyst and removing all the material
can improve the appearance and inflammation, but does not completely treat the
problem and it is likely to recur. Minor surgery to excise the cyst, which our patient opted
for, is the best way of preventing a recurrence, but will probably leave a small yet
permanent scar. Laser and topical treatments are available to correct scarring. Cysts

Valeria Chavez
March 1, 2015

can surgically be removed whole if they have not ruptured and are extremely unlikely to
return, but if the cyst has bursted or is emptied during surgery, surrounding tissue is
removed for precaution and cauterized to prevent regrowth.
Prognosis
If the cyst has been removed in totality, it has a nearly zero percent chance of
returning. If the cyst was ruptured, there is a high chance of it coming back, even if it
was surgically excised.
Any other treatment except for surgery has a risk of recurrence. If the cyst was left
untreated, it may disappear and never return, or continue growing and require
treatment.
Psychological and Social Impact
Cysts and scars are both aesthetically unpleasing, which can lead to issues
when a patient is deciding what course of treatment to take. There are no social issues
about the treatment, but a patient may be affected by the outcome of the procedure,
especially if the cyst does return. Although they are not common in children and young
adults, the psychological problems from cysts can result in low self confidence in
emotionally- sensitive children. After the procedure, patients can go directly from the
clinic to work or school as normal, while following the physicians care instructions,
which usually includes keeping the area covered and changing bandages twice a day.
Works Cited
US National Library of Medicine. "Sebaceous Cyst: MedlinePlus Medical Encyclopedia."
U.S National Library of Medicine. U.S. National Library of Medicine, n.d. Web. 01 Mar. 2015.
Mayo Clinic. "Epidermoid Cysts (sebaceous Cysts)." Sebaceous Cysts Complications.
Mayo Clinic, n.d. Web. 01 Mar. 2015.