eMedicine Specialties > Dermatology > Benign Neoplasms

Epidermal Inclusion Cyst: Treatment & Medication

Author: Linda J Hanson, MD, MA, Resident Physician, Department of Dermatology, State University of New York at Buffalo School of Medicine
Coauthor(s): Nathalie C Zeitouni, MD, CM, FRCPC, Interim Chair of Dermatology, Chief, Dermatologic Surgery, Associate Professor of Dermatology, Roswell Park Cancer Institute and State University of New York at Buffalo
Contributor Information and Disclosures

Updated: Jun 9, 2009

Treatment

Medical Care

Asymptomatic epidermoid cysts do not need to be treated. Intralesional injection with triamcinolone may hasten the resolution of inflammation. Oral antibiotics may occasionally be used.

Surgical Care

Epidermoid cysts may be removed via simple excision or incision with removal of the cyst and cyst wall though the surgical defect.35  If the entire cyst wall is not removed, the lesion may recur. Excision with punch biopsy technique may be used if the size of the lesion permits.36,37 Minimal-incision surgery, with reduced scarring, has been reported.38,39

Incision and drainage may be performed if a cyst is infected. This may facilitate the clearing of infection; however, it will not eradicate the cyst.

The clinical trial, Comparison of Excision Versus Punch Incision in the Treatment of Epidermal Cysts, is currently recruiting.

Consultations

Lesions located in atypical locations warrant appropriate consultation.

Medication

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

Corticosteroids

These agents have anti-inflammatory properties and cause varied metabolic effects.


Triamcinolone (Amcort, Aristocort)

Decreases inflammation by suppressing migration of PMN leukocytes and reversing capillary permeability. Intralesional injections may be used for localized skin disorder.

Adult

2.5-5 mg/mL intralesionally; may repeat in 4-6 wk

Pediatric

<12 years: Not established
>12 years: Administer as in adults

Coadministration with barbiturates, phenytoin, or rifampin decreases effects

Documented hypersensitivity; fungal, viral, and bacterial skin infections

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Multiple complications (eg, severe infections, hyperglycemia, edema, osteonecrosis, myopathy, peptic ulcer disease, hypokalemia, osteoporosis, euphoria, psychosis, myasthenia gravis, growth suppression) may occur; abrupt discontinuation of glucocorticoids may cause adrenal crisis

More on Epidermal Inclusion Cyst

Overview: Epidermal Inclusion Cyst
Differential Diagnoses & Workup: Epidermal Inclusion Cyst
Treatment & Medication: Epidermal Inclusion Cyst
Follow-up: Epidermal Inclusion Cyst
Multimedia: Epidermal Inclusion Cyst
References
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References

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Further Reading

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Keywords

epidermal cyst, epidermoid cyst, epithelial cyst, keratin cyst, sebaceous cyst, milia, basal cell carcinoma, Bowen's disease, SCC, mycosis fungoides, Gardner syndrome, subungual hyperkeratosis, HPV infection, seborrheic keratoses, nevi, subungual epidermoid cyst, terminal phalanx epidermoid cyst, basal cell nevus syndrome, pachyonychia congenita

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Contributor Information and Disclosures

Author

Linda J Hanson, MD, MA, Resident Physician, Department of Dermatology, State University of New York at Buffalo School of Medicine
Linda J Hanson, MD, MA is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

Nathalie C Zeitouni, MD, CM, FRCPC, Interim Chair of Dermatology, Chief, Dermatologic Surgery, Associate Professor of Dermatology, Roswell Park Cancer Institute and State University of New York at Buffalo
Nathalie C Zeitouni, MD, CM, FRCPC is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American College of Mohs Surgery, Dermatology Foundation, International Society for Dermatologic Surgery, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

Julie C Harper, MD, Assistant Program Director, Assistant Professor, Department of Dermatology, University of Alabama at Birmingham
Julie C Harper, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Stiefel Honoraria Speaking and teaching; Allergan Honoraria Speaking and teaching; Intendis Honoraria Speaking and teaching; Coria Honoraria Speaking and teaching; Sanofi-Aventis Honoraria Speaking and teaching

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Christen M Mowad, MD, Associate Professor, Department of Dermatology, Geisinger Medical Center
Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

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