<p>An Unusual and Rare Case of Generalized Multiple Epidermoid Cysts with a Giant Epidermoid Cyst</p>

Abstract

Epidermoid cyst (EC) is a cyst containing keratin and its breakdown products, that is surrounded by an epidermoid wall. EC can occur in both men and women, especially in young- and middle-aged adults. The clinical features of EC include asymptomatic, well-demarcated, and skin-colored to yellowish subcutaneous or dermal nodules with a punctum on the middle of the lesion which can occur anywhere on the body. This type of cyst is usually solitary with diameter up to 5 cm, or rarely, there are multiple with diameters of more than 5 cm, which is classified as a giant EC. Here, we report a case of generalized multiple ECs with a giant EC on the left gluteal region of a 19-year-old male with complaints of asymptomatic skin-colored nodules with central punctum on the right temple, chest, back, and gluteal regions for five years. Correlation between the clinical and histopathological findings in the form of cysts containing keratin and lined by wall composed of stratified squamous epithelia established the diagnosis of EC. The patient underwent surgical procedures for the skin-colored nodules on the chest, back, and gluteal regions. He also received triamcinolone acetonide intralesional injection for the skin-colored nodule on the right temple. After four months of follow-up, there was no recurrence, and all the skin-colored nodules were completely removed. EC should always be considered when diagnosing a skin-colored nodule even if the manifestations are generalized multiple and giant nodules, as in our case, demonstrating a rare and unusual case of EC, to the best of our knowledge.

Diagnosis and therapy of giant epidermoid double cysts with infection on the buttock: A case report and literature review

“…[ 48 ] When an epidermoid cyst gradually increases in size or has recurrent inflammation that affects daily activities, this is an indication for intervention. [ 66 ] Interventions include both non-surgical and surgical treatments. Non-surgical treatment can involve an intralesional injection of triamcinolone acetonide.…”

“…[ 67 ] Surgical treatment techniques include incision and drainage, conventional wide excision (ellipse excision), minimally invasive excision (minimal excision), punch excision, laser excision, and negative pressure suction excision. [ 66 ]…”

“…[67] Surgical treatment techniques include incision and drainage, conventional wide excision (ellipse excision), minimally invasive excision (minimal excision), punch excision, laser excision, and negative pressure suction excision. [66] Conventional wide excision (elliptical excision): The conventional wide excision technique or complete excision of the cyst wall is currently considered the gold standard for the treatment of epidermoid cysts. [18,36,47,68] Because complete excision reduces the probability of recurrence.…”