Epidermoid and Pilar Cysts

Question 1

Define epidermoid and pilar cysts.

Answer 1

Epidermoid cysts, also called sebaceous, keratin, or epithelial cysts, are small, hard lumps that develop under the skin. These cysts are common. They grow slowly. They do not cause other symptoms and are nearly never cancerous. About 1% of these may progress to SCC or BCC.

Question 2

Explain the aetiology/risk factors of epidermoid and pilar cysts.

Answer 2

HPV infection
Acne
Excessive exposure to the sun
Other skin conditions
Male

Question 3

Summarise the epidemiology of epidermoid and pilar cysts.

Answer 3

Epidermoid cysts are the most common cutaneous cysts and typically occur in the third and fourth decades of life.

Question 4

Recognise the presenting symptoms of epidermoid and pilar cysts. Recognise the signs of epidermoid and pilar cysts on physical examination.

Answer 4

Epidermoid cysts are often found on the face, head, neck, back, or genitals. They can range in size from 1/4 inch to 2 inches across. They look like a small bump, are tan to yellow in color, and are filled with thick, smelly matter. They do not cause any pain and can usually be ignored.

Question 5

Identify appropriate investigations for epidermoid and pilar cysts and interpret the results.

Answer 5

No investigations are necessary. They can be diagnosed by examination only. Sometimes an ultrasound may be used.

Question 6

What is the management for epidermoid and pilar cysts?

Answer 6

Can leave this alone if it’s not causing any problems.

Injection with corticosteroid

Incision and drainage - can reoccur

Excision - very effective

Question 7

What are complications associated with epidermoid and pilar cysts?

Answer 7

Infection of the cyst

Inflammation

Rupture