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Cysts forming during wounds, biopsy showed epithelial cysts. Painful, skin does not heal. What can cause this?

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ENT Specialist
Practicing since : 1992
Answered : 332 Questions
I have a strange condition, that I have not been able to get any answers or diagnosis for. Whenever I have a wound, cut or surgical incision I get little cysts that form in the area inhibiting the healing process of the wounds. I was able to get a couple biopsied, which informed me they were epithelial cysts. The best medical description I have found that fits is Proliferating Epidermoid Cysts.

I have searched for answers as to what can cause epithelial cysts in cases like this and have found no answers. I get them on my labia, head, arms, legs, neck, back, breasts, even in my mouth after I had a couple teeth removed they were in the cavity.

They hurt to the touch, my skin won't heal around them leaving sores or wounds open until the cysts get removed. I have been dealing with this for over 8 years now, its making life very difficult. What can cause this?
Posted Sat, 9 Jun 2012 in Ear, Nose and Throat Problems
Answered by Dr. Ravinder Sharma 22 hours later
Thanks for writing in.
On the basis of the information provided, I would like to tell you about the disease you are suffering from. Skin has an outer layer called as epidermis and a deeper layer called as dermis. Proliferating epidermoid cysts refers to the proliferation of epidermal cells in the dermis. It is a rare type of cyst. Common causes include sequestration of epidermis in the dermis during embryonic life (congenital cause), blockade of the pilosebaceous unit or surgical implantation of epidermal lining in the deeper layer of skin called as dermis (appears to be a cause in your case). As the epithelium proliferates, there is deposition of cheesy material in the cyst. Sometime it gets infected and may turn painful with discharge (at times may it be blood stained)
Usually it has a punctum ( a small hole like opening) and can have some skin discoloration. Rarely, it may turn more aggressive -- called as malignant proliferating epidermoid cyst. The best way to diagnose is by the histopathology of the excised specimen. If you ever notice a rapidly progressive course of the cyst you have to be more alert and would need medical help in a hospital as it may be the malignant variant of the cyst.

Treatment is
If it is small and not infected, intralesional steroids may help. If it is infected, it may require drainage, antibiotics for secondary infection and drainage. As the infection resolves, repair of the wound is needed.
Long standing cases may have scarring. If attended in time, general outlook is good.

I would suggest that you need not worry about them as they have a self limiting course
If you experience pain and discomfort or a sudden increase in the size of swelling, you need medical attention in a hospital

I hope this answers your concern. Do let me know if you need more help

with regards
Ravinder Sharma
Above answer was peer-reviewed by
Follow-up: Cysts forming during wounds, biopsy showed epithelial cysts. Painful, skin does not heal. What can cause this? 1 hour later
I just recently had carpal tunnel surgery and he incision opened up and numerous cysts could be seen. The stitches were removed 10 days after surgery and the incision opened up three days after they were removed. I also had cubital tunnel release and the dissolvable stitches in my elbow are forcing their way out. Should I refrain from surgery at all costs? Should I refrain from dissolvable sutures? Could using steri-strips lessen the problem? I have an appointment with my surgeon tomorrow and I don't know what to tell him.
Answered by Dr. Ravinder Sharma 10 hours later
Thanks for writing back
Possible causes of delayed wound healing may be related to your skin disease or can be because of secondary infection or systemic disease like diabetes. You will require some tests to rule out other possible causes of delay in wound healing.
Instead of you having to refrain from surgery or dissolvable sutures, I think we should be looking at addressing the main cause of the problem.
I would suggest you to see a dermatologist along with the general surgeon's opinion and discuss about the histopathology report with them.
I hope this answers your concern . Do let me know if you require further information
with regards
Ravinder Sharma
Above answer was peer-reviewed by
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