聚桂醇泡沫硬化剂治疗颜面部皮脂腺囊肿的临床观察

目的观察聚桂醇泡沫硬化剂治疗颜面部皮脂腺囊肿的临床疗效。方法对62例颜面部皮脂腺囊肿的患者,随机分为观察组与对照组,两组患者均采用微创穿刺搔刮术清除囊内容物,庆大霉素注射液及生理盐水冲洗,观察组患者采用聚桂醇泡沫硬化剂囊腔内注射,对照组患者采用复方倍他米松注射液囊腔内注射。于首次治疗后第4、8周复诊,观察两组患者的治疗效果及复治情况,于第12周评价临床疗效及不良反应情况,治疗结束后6个月内随访观察复发率及皮损情况。结果首次治疗后第8、12周两组间囊肿直径及第8周复治例数比较,差异均有统计学意义(P0.05);两组第12周临床疗效、不良反应及治疗结束后6个月内复发例数比较,差异有统计学意义(P0.05);观察组有效率高于对照组,临床疗效优于对照组,皮损表面不良反应低于对照组。结论聚桂醇泡沫硬化剂注射治疗颜面部皮脂腺囊肿,疗效优越,创伤小、复发率低。     

微切口手术治疗感染期皮脂腺囊肿临床疗效观察

目的:探讨微切口皮脂腺囊肿囊腔摘除术治疗感染期皮脂腺囊肿的临床疗效。方法:选取该院2015年2月—2017年2月收治的127例皮脂腺囊肿感染患者。术前予抗炎治疗,采用微切口皮脂腺囊肿囊腔摘除术,术后视切口愈合情况对症治疗。结果:本组127例皮脂腺囊肿感染患者中,治愈120例(94.49%),显效6例(4.72%),无效1例(0.79%),有效率为99.21%。随访3个月后复发1例(0.79%)。结论:微切口皮脂腺囊肿囊腔摘除术治疗感染期皮脂腺囊肿疗效显著,术后愈合良好,切口小,复发率低。     

高频电针微钻孔法治疗皮脂腺囊肿21例

我科近年试用高频电针微钻孔法治疗皮脂腺囊肿,效果满意,现报告如下。一、临床资料1991年5月～1992年10月,门诊皮脂腺囊肿患者21例共75个皮损。病人年龄16～54岁。皮损为边:界清楚的圆形囊性肿物与表皮粘连,绿豆至蚕豆大小,部位以面颈部为主无炎症。二、治疗方法选用绵阳产SS6A腋臭治疗仪,工作电压220V,频率5f0Hz,功率50W.皮损处常规消毒,局麻下皮损中央用高频电针点状烧灼一米粒大小洞至皮下囊壁处,若囊肿较小用纹式血管钳直接分离剥出,若囊肿较大则继续用高频电针在襄壁上打一小洞,挤出腔内全部皮脂后用纹式钳取出囊壁。术后若遇出血则用高频电针烧灼止血。术后不缝合伤口,外涂2%龙胆紫液。     

囊壁刮除法治疗皮脂腺囊肿45例

自１９９２年以来，我们采用囊壁刮除法治疗４５例皮脂腺囊肿，取得满意效果，报告如下。临床资料：４５例中男３４例，女１１例，手术后复发３例。年龄１８～３９岁，病程２～１７年。皮损主要分布胸部、背部、臀部及面部，其中２例囊肿超过１０个以上。治疗方法和结果：...     

微创摘除术治疗颜面部皮脂腺囊肿46例

本科自2000年2月-2005年5月应用微创摘除术治疗颜面部皮脂腺囊肿46例，取得了满意疗效，现报告如下。     

皮脂腺及皮下脂肪疾病

20 0 0 182 9　二氧化碳激光气化打孔治疗面部囊肿性痤疮 /邢勇君 (湖北十堰市东风汽车公司中心医院皮肤科 )…∥中华理疗杂志 .- 1999,2 2 ( 5) .- 315采用二氧化碳激光机 ,术时左手将囊肿捏起 ,光针与囊肿表面垂直 ,在囊肿中心聚焦气化一直径 1～2 mm小孔 ,穿透囊壁后去焦痂再继续气化 3～ 5秒 ,然后挤出囊内物质。挤压干净后用蚊式血管钳夹住囊壁边摇边拉 ,囊壁全部拉出后在小孔涂 2 .5%碘酊后盖敷料包扎。对照组采用强的松龙混悬液囊肿内注射 ,每周 1次 ,共 1～ 3次。结果 :治疗 3个月后激光组、对照组治愈、显效、好转、无效分别为 2 3…     

小切口囊壁翻转法治疗颜面部皮脂腺囊肿86例

我们于１９９０年～１９９８年用小切口囊壁翻转法治疗皮脂腺囊肿８６例，现报告如下。临床资料８６例中，男６０例，女２６例，年龄１５～４７岁，病程１月～３年。皮损分布于额、面部；少者１个，多者数个。８６例患者共有囊肿１０５个，其中直径小于１．５ｃｍ的２３个...     

全身多发性脂囊瘤

报告1例全身多发性脂囊瘤.患者男,40岁.因全身泛发囊肿30年就诊.无家族史.组织病理检查示真皮至皮下有不规则囊腔,囊壁为复层鳞状上皮,无颗粒层,与多个皮脂腺相连接.诊断:多发性脂囊瘤.患者未接受治疗.     

微波治疗皮脂腺囊肿50例

近两年来 ,我们用电子工业部四十三研究所恒力技术公司生产的ＷＮＺ -ＩＣＤ -Ⅱ多功能微波治疗机治疗 5 0例皮脂腺囊肿患者 ,取得满意效果 ,现报告如下。1　临床资料　 5 0例皮脂腺囊肿患者中 ,男性 3 7例 ,女性 13例。年龄 18～ 3 5岁。病程 2周～ 2年。囊肿大小为米粒至花生米大小。部位多在头面、胸背及臀部 ,以头面部最常见。囊肿多为单发 ,有 8人在临近部位长有 2～ 3个大小不等的囊肿。所有患者均有反复挤压囊肿史 ,并挤出白色豆渣样物 ,伴有不同程度的酸腐臭味。检查囊肿 ,壁光滑 ,质中等硬 ,活动度好 ,与皮肤及周围组织无粘连 ,无…     

丹参针局部注射联合中药内服治疗囊肿型痤疮的临床疗效观察

目的丹参针局部注射联合中药内服,探索一种安全有效治疗囊肿型痤疮的方法。方法将60例囊肿性痤疮患者按随机数字表法分为2组各30例,同时口服中药(海藻玉壶汤加味)及外用夫西地酸软膏,疗程12周。2组均常规消毒冲洗囊腔,用针头斜面对囊壁进行部分剥除,治疗组将丹参针注入囊腔内,1次/周,患者均于3个月后判断疗效。结果治疗组有效率为86.67%;对照组有效率为63.33%,2组差异有统计学意义(P0.05)。结论丹参针局部注射联合中药内服治疗囊肿型痤疮疗效满意,安全有效,值得推广应用。     

Hybrid follicular cyst (pilomatrical and infundibular) arising within a sebaceous nevus

A 7-year-old girl presented with a 3-month history of a small blue-brown papule arising within a large sebaceous nevus on her temporal scalp. A punch excision was performed that demonstrated a hybrid follicular cyst. The majority of the cyst wall displayed pilomatrical differentiation consisting of basaloid matrical-type cells with luminal shadow cell keratinization. The matrical epithelium displayed strong membranous, cytoplasmic, and nuclear staining for β-catenin. Only a small component of the wall displayed infundibular differentiation. These findings were consistent with a hybrid follicular cyst predominantly displaying pilomatrical differentiation with only a small component of infundibular lining. The most common tumors arising within sebaceous nevi are the syringocystadenoma papilliferum and trichoblastoma. Follicular cysts with infundibular (sebaceous cyst) and trichilemmal (pilar cyst) differentiation are exceedingly common, although their development within sebaceous nevi appears to be rare. We report a rare case of a hybrid follicular cyst with matrical differentiation occurring within a sebaceous nevus.     

Intratarsal keratinous cysts of the meibomian gland (a sebaceous duct cyst): report of 2 cases

Intratarsal keratinous cyst of the meibomian gland is a recently described entity that recurs if not completely excised. Herein, we report 2 cases and discuss their diagnosis and management: (1) A 57-year-old man with a recurrent mass of the upper eyelid treated with incision and drainage as a chalazion for more than 5 years and (2) An 85-year-old man presented with a slow growing nodule of the upper eyelid. Exploration via the eyelid crease approach revealed cysts fixed to the tarsus that were completely excised with a portion of the anterior tarsus. Histologically, these cysts exhibited a keratinizing squamous epithelium without a granular layer (trichilemmal keratinization), were lined by an eosinophilic undulating cuticle, contain string-like keratin debris, and had a fibrous wall without sebaceous lobules. All epithelial components strongly expressed high-molecular weight keratins, whereas the lining, cuticle, and keratin contents strongly expressed carcinoembryonic antigen. No recurrence has occurred 7 and 12 months postoperatively. The location and clinicopathologic findings of intratarsal keratinous cysts distinguish it from sebaceous tumors, steatocystoma simplex, epidermoid cyst, and dermoid cyst. However, like steatocystomas, intratarsal keratinous cysts exhibit a sebaceous duct phenotype. The anterior lid crease approach with partial tarsectomy seems to be an effective treatment.     

A new method for facial epidermoid cyst removal with minimal incision

Background  Facial epidermoid cyst is a common benign epithelial tumour frequently seen in young or middle-aged people and may cause aesthetic disability. Surgical excision is the most frequently used method but may result in obvious scar.
Objective  To improve cosmetic result of removing facial epidermoid cyst through minimal incision surgery.
Methods  Twenty-two cases of facial epidermoid cysts ranging from 0.5  to 1.4 cm in diameter were treated. The skin above the epidermoid cysts was infiltrated with local 0.1-cc 1% xylocaine anaesthetic by using a 26-gauge needle first, then 3-mm incisions were made with a No.11 surgical blade. The cystic contents and its capsule were then squeezed out through the small incision and the underlying connective tissue was chemically cauterized by 20% trichloroacetic acid. The incision wounds were left unsutured.
Result  Minimal incision method successfully treated 16 out of the 22 epidermoid cyst cases that ranged from 0.5 to 1 cm in diameter. And only one out of six was successfully treated for diameters greater than 1.1 cm.
Conclusion  The proposed method can minimize the scar when treating facial epidermal inclusion cysts that are less than 1 cm and obtained better cosmetic results.

Conflicts of interest

None declared.     

Cutaneous cysts of Gardner's syndrome are similar to follicular stem cells

Cutaneous cysts from a patient with Gardner's syndrome were histopathologically studied in detail. The cysts were, by and large, indistinguishable from ordinary epidermal cysts. However, several distinctive features were found: 1) epidermal or trichilemmal keratinization, 2) mature sebaceous glands connected with the cyst wall, 3) hair matrix-like structures associated with dermal papilla cells, 4) pilomatricoma-like changes, 5) intraluminal masses or pericystic deposits of shadow cells variably accompanied with foreign body reaction, 6) foreign body reaction or masses of shadow cells lining completely eroded cysts, 7) the presumptive bulge area, and 8) epithelial islands adjacent to the cyst. Each cutaneous cyst showed a variable combination of the findings described above. Foci of the basal layer of some cyst walls or epithelial islands were immunohistochemically stained with CK19, where CK20-reactive Merkel cells were also present. These Findings were consistent with those of the bulge area. Unexpectedly, desmin-reactive muscle bundles, presumably indicating arrector pili muscle, were observed along the cyst wall. Our observations suggest that Gardner's cysts may be derived from putative follicular stem cells which reside in the bulge area.     

Multiple pigmented follicular cysts: a subtype of multiple pilosebaceous cysts

Summary Pigmented follicular cyst is a rare disorder which typically presents as a pigmented papule on the head or neck and which, histologically, exhibits terminally differentiated, pigmented hair shafts in an epidermoid cyst. We report a 22-year-old man with the multiple variant of this disorder. Clinically he had numerous brown-blue to flesh-coloured, domed-shaped papules, on the anterior chest and abdomen, of 10 years duration. Histologically, hybrid cysts exhibiting trichilemmal and epidermoid keratinization were seen. The cysts contained numerous pigmented. Terminally differentiated hair shafts and embedded in the wall of one cyst, was a sebaceous gland. The condition of multiple pigmented follicular cysts, is thought to represent a distinct subtype within the spectrum of multiple pilosebaceous cystic disorders.     

Presternal Dermoid Cyst Mimicking Lymphatic Malformation: a Case Report and Review of the Literature

Abstract: We describe an 11‐month‐old boy with an unusually large presternal mass present since birth. The large size, fluctuant properties, transillumination, compressibility, and imaging of this lesion were characteristic of a lymphatic malformation. Although four treatments with sclerotherapy markedly reduced its size, it was not until definitive treatment with surgical excision and the final pathology report that we arrived at the ultimate diagnosis of dermoid cyst. Dermoid cysts, although appearing along embryologic lines of closure, are rarely presternal. They are usually small, thick walled, and filled with sebaceous or keratinous fluid, which typically allows for clinical diagnosis, and show characteristic features on magnetic resonance imaging (MRI) and ultrasound. However, this case illustrates that dermoid cysts can appear in somewhat atypical locations, and imaging is not always diagnostic, so dermoid cyst should remain a part of the differential diagnosis for any lesion presenting midsternally, regardless of the size and imaging characteristics.     

Mycotic cysts: report of 21 cases including eight pheomycotic cysts from Saudi Arabia

BACKGROUND: Mycotic cysts are subcutaneous cystic granulomas caused by either dematiaceous (pigmented) fungi (pheomycotic cysts) or eumycotic (nonpigmented fungi) present in soil, wood, and decaying plant material. These fungi gain access to the tissues via a wooden splinter or thorn. No deep tissue involvement or extension to bone is known to occur. METHODS: We reviewed our surgical pathology files for the last 32 years. All cases with the diagnosis of cysts with fungi, thorns, or splinters and associated granulomatous and acute inflammation were reviewed. Gomori's silver and periodic acid-Schiff stains were performed in all cases. RESULTS: Twenty-one cases of mycotic cyst were found, including eight pheomycotic cysts (one with a recurrent lesion seen 11 months after the initial excision of the cyst). Thirteen cysts had nonpigmented fungal hyphae. There were 14 males and seven females, with an age range of 5-76 years. The dorsum of the foot was the most frequently affected site (12 cases). Four cases involved the fingers, two involved the knee area, two involved the big toe, and one each involved the leg, ankle, and forearm. The cysts measured 0.6-4.5 cm in diameter. Histologically, there was granulomatous inflammation with a variable degree of neutrophilic infiltrate giving central abscess formation. Twelve cases showed a wooden splinter. All cases were positive for fungal organisms, mostly septate hyphae and spores that were highlighted by special stains. Fungal pigment, ranging from yellow-brown to light brown to black, was observed in eight cases. No extension to deep tissues was noted. The clinical impression varied widely including ganglion, sebaceous cyst, giant cell tumor of the tendon sheath, and lipoma. One patient was immunosuppressed following renal transplantation. All patients were treated by simple excision. No antifungal chemotherapy was needed or administered in any of the patients. One patient had a recurrence of his lesion within 1 year as a result of inadequate initial excision. A second re-excision was curative. CONCLUSION: Mycotic cysts are uncommonly encountered lesions that can be easily missed, especially in cases with scant fungal elements, thus requiring special stains to detect the organisms. We reported 21 cases of mycotic cyst, including eight pheomycotic cysts, with emphasis on the histopathologic recognition of this unusual entity.     

Cutaneous keratocysts of nevoid basal cell carcinoma syndrome

Four cysts were removed from two unrelated patients with nevoid basal cell carcinoma syndrome. Multiple sections from each cyst were studied. Two cysts showed histologic features similar to keratocysts that occur in the jaws of patients with this syndrome. The cysts were lined by a festooned epithelium consisting of two to five layers of squamous cells that formed keratin without the presence of a granular cell layer. One cyst contained some lanugo hair and a small bud of follicular epithelium. This cyst was therefore similar to cutaneous steatocysts but did not have an identifiable sebaceous component. The second cyst was devoid of hair and adnexal structures and was indistinguishable from a jaw keratocyst. Two other cysts were typical epidermoid (infundibular) cysts. Although speculative, it is likely that some cutaneous cysts in patients with nevoid basal cell carcinoma syndrome are identical to jaw keratocysts and may be another cutaneous marker for this disease complex.     

A simple surgical technique for the treatment of steatocystoma multiplex

BACKGROUND: Since steatocystoma multiplex is an uncommon disorder, its treatment has not been discussed in detail in the textbooks and surgical excision is the most commonly mentioned method. In this article, we describe a very simple surgical technique, which was developed by modifying previous reports. METHODS: A 29-year-old woman, diagnosed clinically and histologically as steatocystoma multiplex, was treated with this modified technique. We punctured the cysts under local anesthesia with a sharp-tipped cautery point and evacuated the contents by squeezing the cyst with a fine forceps. Then, the cyst wall was grasped by the forceps and the sacs were extracted through small holes. More than 50 cysts were treated. RESULTS: The treatment was well tolerated by the patient. No complications developed during or after the procedure. After 14 months follow up no recurrences were observed and the results were cosmetically excellent. CONCLUSIONS: This modified technique is very simple and time saving. Its cosmetic and long-term results are successful. We believe that it must be considered as the treatment of choice for steatocystoma multiplex.     

Eruptive vellus hair cysts with sebaceous glands

A patient is described who had eruptive vellus hair cysts with and without sebaceous glands in the cyst walls. An association is suggested between eruptive vellus hair cysts and the condition of steatocystoma multiplex.