Common Skin Lesions: Cysts

Question 1

Which is this Cyst? Round, yellow/flesh-coloured,
slow growing, mobile, firm,
fluctuant, nodule or tumour

Answer 1

Epidermal Cyst

Question 2

Which is this Cyst? Multiple, hard, variable sized
nodules under the scalp, lacks
central punctum

Answer 2

Pilar Cyst

Trichilemmal

Question 3

Which is this Cyst?
Firm nodule most commonly
found at lateral third of
eyebrow or midline under
nose

Answer 3

Dermoid Cyst

Question 4

Which is this Cyst? Usually solitary, rubbery,
translucent; a clear gelatinous
viscous fluid may be extruded

Answer 4

Ganglion Cyst

Question 5

Which is this Cyst? 1-2 mm superficial, white to
yellow subepidermal papules
occurring on eyelids, cheeks,
and forehead

Answer 5

Milium

Question 6

Which is this Cyst? Pathophysiology: Small epidermoid cyst, primarily arising from
pluripotential cells in epidermal or adnexal
epithelium
Can be secondary to blistering, ulceration,
trauma, topical corticosteroid atrophy, or
cosmetic procedures

Answer 6

Milium

Question 7

Which is this Cyst? Pathophysiology: Cystic lesion that originates from joint or
tendon sheath, called a digital mucous cyst
when found on fingertip
Associated with osteoarthritis

Answer 7

Ganglion Cyst

Question 8

Which is this Cyst? Pathophysiology: Rare, congenital hamartomas, which arise
from inclusion of epidermis along embryonal
cleft closure lines, creating a thick-walled
cyst filled with dense keratin

Answer 8

Dermoid Cyst

Question 9

Which is this Cyst? Pathophysiology: Thick-walled cyst lined with stratified
squamous epithelium and filled with dense
keratin
Idiopathic
Post-trauma

Answer 9

Pilar Cyst

Trichilemmal

Question 10

Which is this Cyst? Pathophysiology: Epithelial cells displaced into dermis,
epidermal lining becomes filled with keratin
and lipid-rich debris
May be post-traumatic, rarely syndromic

Answer 10

Epidermal Cyst

Question 11

Which is this Cyst? Epidemiology
2nd most common
cutaneous cyst
F>M, hereditary

Answer 11

Pilar Cyst

Trichilemmal

Question 12

Which is this Cyst? Epidemiology
Most common
cutaneous cyst in
youth – middle age

Answer 12

Epidermal Cyst

Question 13

Which is this Cyst? Epidemiology
Any age
40-50% of infants

Answer 13

Milium

Question 14

Which is this Cyst? Epidemiology

Older age

Answer 14

Ganglion Cyst

Question 15

Which is this Cyst? Epidemiology

Rare

Answer 15

Dermoid Cyst

Question 16

Clinical Course of Milium

Answer 16

In newborns, spontaneously resolves

in first 4 wk of life

Question 17

Clinical Course of Ganglion Cyst

Answer 17

Stable

Question 18

Clinical Course of Dermoid Cyst

Answer 18

If nasal midline, risk of extension

into CNS

Question 19

Clinical Course of Pilar Cyst

Trichilemmal

Answer 19

Rupture causes pain and

inflammation

Question 20

Clinical Course of Epidermal Cyst

Answer 20

Central punctum may rupture (foul,
cheesy odour, creamy colour) and
produce inflammatory reaction
Can increase in size and number
over time

Question 21

Management of Epidermal Cyst

Answer 21

No treatment

Elective excision

Question 22

Management of Pilar Cyst

Trichilemmal

Answer 22

No treatment

Elective excision

Question 23

Management of Dermoid Cyst

Answer 23

No treatment

Elective excision

Question 24

Management of Ganglion Cyst

Answer 24

No treatment
Incision and expression
of contents
Elective excision

Question 25

Management of Milium

Answer 25

No treatment
Incision and expression
of contents
Electrodessication
Topical retinoid therapy