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Epidermoid cyst in Child
See also in: Anogenital,Hair and Scalp
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Epidermoid cyst in Child

See also in: Anogenital,Hair and Scalp
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Contributors: Susan Burgin MD, Belinda Tan MD, PhD, Craig N. Burkhart MD, Dean Morrell MD
Other Resources UpToDate PubMed

Synopsis

Epidermoid cysts (epidermal cyst, epidermal inclusion cysts, keratin cysts) are frequently incorrectly called sebaceous cysts. One of the most common benign skin tumors in adults, epidermoid cysts are rare in childhood and infancy. These semi-solid cysts are lined by a keratinizing epithelium and filled mostly with macerated keratin, which has a cheese-like consistency and pungent odor. They frequently appear to arise spontaneously. Alternatively, they may result from disruption of follicular structures or by implantation of the epidermis via a penetrating injury. Epidermoid cysts are a feature of several hereditary syndromes, such as Gardner syndrome; cysts are usually multiple and in unusual locations in Gardner syndrome.

Codes

ICD10CM:
L72.0 – Epidermal cyst

SNOMEDCT:
419893006 – Epidermoid cyst

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Epidermoid cysts are rare before puberty, and alternative diagnoses should be strongly considered in infancy and childhood.

Cyst rupture with associated inflammation is often misdiagnosed as an "infection" of the cyst. Cultures are usually negative, and treatment with antibiotics is not required.

Superficial lymph nodes are palpated within the subcutaneous fat and are found within the course of lymphatics.
  • Lipomas are soft, mobile subcutaneous nodules with normal overlying epidermis.
  • Pilar cysts (trichilemmal cysts) may be clinically indistinguishable from epidermoid cysts but are more common in childhood and are typically found on the scalp.
  • Pilomatricoma usually presents as a solitary skin-colored to faint blue nodule, frequently found on the head or upper trunk in children. Firmness is a reflection of calcification within this benign tumor.
  • Steatocystomas occur as asymptomatic single or multiple cysts on the chest, axillae, and/or groin that may drain an oily substance if punctured. Multiple steatocystomas are seen in some patients with pachyonychia congenita.
  • Dermoid cysts result from anomalies in embryonic closure zones. Surgical removal or biopsy of a cyst over the midline should not be attempted without proper imaging to rule out intraspinal or intracranial connection.
  • Thyroglossal duct cysts present as midline cystic nodules on the neck in children.
  • Branchial cleft cysts present in the second or third decade as a nodule in the preauricular area, mandibular region, or along the anterior border of the sternocleidomastoid muscle.
  • Bronchogenic cysts are most frequently found in the suprasternal notch, and they represent sequestered respiratory epithelium during embryological development.

Best Tests

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Therapy

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References

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Last Reviewed: 05/09/2017
Last Updated: 06/13/2017
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Epidermoid cyst in Child
See also in: Anogenital,Hair and Scalp
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Epidermoid cyst : Cyst, Face, Neck, Smooth nodule, Trunk
Clinical image of Epidermoid cyst
A close-up of a yellowish nodule with a central keratin-filled punctum.
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