Epidermoid cysts in the hand

Abstract

This study details our series of epidermoid cysts in the hand, characterising the incidence, clinical characteristics and recurrence rate after marginal excision. A historical cohort of 101 epidermoid cysts that were excised from a soft tissue or intraosseous location in the hand over a 27 year period were reviewed. The incidence of epidermoid cysts, patient age, sex, occupation, anatomic location, history of trauma, treatment complications and cyst recurrence rate were noted. Key findings of the study were as follows. Epidermoid cysts represented a significant portion of our relatively large series of hand tumours. The majority occurred in male patients, most often involving the soft tissues on the palmar aspect of the hand. Four percent were intraosseous epidermoid cysts. After excision with a marginal tumour margin we found that 11 cysts (11%) recurred.

Epidermoid cysts localized on extremities

“…We think that the reason for this is; form of treatment is converted from marginal excision to intralesional excision by having intraoperative rupture, because the surrounding tissue is contaminated by the pathological cell planting via intralesional excision. [6] As a result of the data obtained from the present study, depending on the hypothesis that the skin on the cyst with/ without trauma history is defective to be predisposed to epidermoid cyst formation and possible defects on such site may allow transmission of epidermal formations into the dermis, we recommend removal of the cysts with cutaneous islets. Despite the current literature, we observed that intraoperative rupture is a reason for relapse of the cyst in the present study and concluded that this may be reduced by excision with cutaneous islet on the cyst.…”

“…[10] Epidermoid cysts of the hand are commonly observed on volar side of the hand and fingers and it is believed that cysts localized on the hand appear as a result of implantation of epidermal elements into dermis after a trauma. [6,11] Lincoski et al [6] found the incidence ratio of epidermoid cyst as 16% in their study where 623 masses were localized on the hand and forearm. Since we only evaluated cases that were diagnosed as epidermoid cyst histopathologically, we cannot provide such a ratio; however, we detected that 50% (n=60) of the cases were localized on the hand and forearm.…”

“…Studies have been performed on a limited number of anatomic regions such as hand or foot only. Except the case series of Dutta et al [5] including 28 cases with head and neck cysts and Lincoski et al [6] including 101 cases with hand cysts, others were case reports. As far as we know, there is no study on epidermoid cysts localized on the extremities.…”

“…Nevertheless, Lucas [18] reported a relapse ratio of 17% in their study and suggested that relapse is associated with incomplete excision. Lincoski et al [6] found a relapse ratio of 11% and reported that preoperative rupture of the cyst is not correlated with relapse and relapse was considered to be caused by incomplete excision rather than intraoperative cyst rupture. For this purpose, such authors recommended to perform excision of the cyst with the skin including scar tissue in patients with penetrating trauma history.…”

Palmar epidermoid inclusion cyst mimicking Dupuytren's contracture

“…Dupuytren's nodules, ganglion cysts, and tendon sheath-induced tumors are the most common structures in palmar side of the hand [1,2]. Epidermoid inclusion cysts are frequently observed in hairy areas such as scalp, face, neck, and scrotum [3,4].…”