Epidermal Inclusion Cyst

KEY FEATURES

• Firm dermal papule or nodule

• Overlying black comedone or "punctum"

• Expressible foul-smelling cheesy material

• May become red and drain, mimicking an abscess

CLINICAL FINDINGS

• Benign growths of the upper portion of the hair follicle

• Common in Gardner syndrome and may be the first stigmata of the condition

• Favor the face and trunk

• May complicate nodulocystic acne vulgaris

• Individual lesions range in size from 0.3 cm to several centimeters

DIAGNOSIS

• Cultures of the expressed material will be sterile

TREATMENT

• Not required if asymptomatic

• Small (1–3 cm) lesions can be treated with a punch incision and removal of cystic contents

• Inflamed lesions may be treated with incision and drainage or intralesional triamcinolone acetonide 5–10 mg/mL

• For large or symptomatic cysts, surgical excision is curative