Medication Summary
Many medications have been used for the treatment of digital mucous cysts. At present, injectable corticosteroids commonly are used, and the most frequently administered agent is triamcinolone acetonide. If a ruptured or partially treated cyst becomes infected, antibiotic therapy with a penicillin or cephalosporin (eg, cephalexin) may be indicated. Silver nitrate and heparin cream also have been used. Currently, no standard doses exist for heparin or for silver nitrate.
Corticosteroids
Class Summary
Corticosteroid therapy may result in involution or shrinkage of the cyst. These agents have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.
Triamcinolone (Aristocort)
Triamcinolone is used in dermatology for its anti-inflammatory and antipruritic properties. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability. Dilute triamcinolone with isotonic sodium chloride solution to a concentration of 2.5-5 mg/mL prior to injection. The total quantity injected may be 0.10 mL or less and a 30-gauge needle is used.
Anti-infectives
Class Summary
These agents treat skin and skin structure infections caused by susceptible organisms.
Cephalexin (Keflex, Biocef)
Cephalexin is a first-generation cephalosporin that arrests bacterial growth by inhibiting bacterial cell wall synthesis. Cephalexin has bactericidal activity against rapidly growing organisms. Its primary activity is against skin flora, and it is used for skin infections or prophylaxis in minor procedures.
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Digital mucous cyst proximal to nail unit.
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Digital mucous cyst at proximal nail fold.
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Histopathology of digital mucous cyst.