![]() ![]() The patient reported that she did not have any known allergies, was not taking any prescription medications, and did not smoke, drink alcohol, or use recreational drugs. She did not have any known comorbidities. The patient’s medical history was largely unremarkable, and the patient appeared otherwise healthy. 1, 2 Epidermoid cysts are uncommon before puberty, and their appearance earlier in life is considered more suspicious. 1 Although these lesions are considered benign, 1% may become malignant and transform into squamous cell or basal cell carcinomas. 1, 2 This inflammatory process may also occur when a cyst ruptures, and it may resemble a furuncle with tenderness to palpation, erythema, and swelling. 1, 2 Occasionally, epidermoid cysts may become infected, which causes them to grow in size, and become inflamed, fluctuant, erythematous, and painful. Uncomplicated epidermoid cysts may remain stable and asymptomatic or may progressively enlarge, with spontaneous inflammation and rupture occurring unpredictably. ![]() ![]() 1 A diagnosis of an epidermoid cyst can be made clinically, but it can be confirmed with histology, which would reveal an epithelial lined-cyst filled with laminated keratin in the dermal layer. 1 They can occur anywhere on the body, but most commonly on the face, neck, trunk, and back they occur more commonly in males and, typically they appear in the third or fourth decades of life. Cysts may range in size from a few millimeters to several centimeters in diameter. 1, 2 Epidermoid cysts typically present as flesh-colored nodules with a visible central punctum or pore which may discharge a foul-smelling, cheese-like keratin material. 1 Epidermoid cysts may also form secondary to trauma to the skin. 1 A similar pathogenesis occurs in the formation of acne vulgaris, which may occur with multiple epidermoid cysts originating from comedones. 1 Epidermoid cysts form via disruption of the infundibulum of the hair follicle by implantation of the epithelium. They are sometimes improperly referred to as sebaceous cysts, though the contents of epidermoid cysts and sebaceous cysts are keratin and sebum, respectively. They may also be referred to as epidermal cysts, epidermal inclusion cysts, or infundibular cysts. Epidermoid cysts are a common class of cutaneous cyst. ![]()
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