Dermoid Cyst – Implantation Dermoid


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It is an acquired dermoid and arises from indriven epithelium beneath the skin due to a puncture injury e.g. needle prick or thorn prick.

Common sites are

  • Palm of the hand
  • Fingers
  • Sole

It is is quite common in gardeners, tailors and women.

Pathology

Cyst is usually lined by stratified squamous epithelium with no hair follicle, sweat and sebaceous glands. The content is white cheesy material formed by desquamated epithelial cells and sebium. Hair is usually absent.

Clinical Features

History:

A history of puncture injury is usually available. In some cases the patient often forgets of such injury.

Symptoms:

A swelling in the finger or the palm is usually the presenting feature. The cyst may be slightly painful.

Examinations:

A tense cystic swelling is found in the finger or the palm.  The consistency is often firm or even hard. There may be a scar on the skin overlying the cyst. Fluctuation is very difficult to elicit as the cyst is small and tense.

The most important clinical feature is the presence of a tense cyst in the finger or the palm with a previous history of a punctured wound.

Complications

  1. Infection
  2. Suppuration
  3. Bursting

Treatment is complete excision of the cyst.

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