Pathophysiology
Epidermal cysts occur as a result of the proliferation of epidermal cells in the dermis circumscribed space. In the analysis of epidermal cysts, lipid structure and the same pattern as in the cells of the epidermis. Epidermal cyst express cytokeratin 1 and 10. The source of the epidermis is almost always from the infundibulum of hair follicles.
Inflammatory mediated by section epdiermal keratinized cysts. In the study, the extract keratin is chemoactive for PMN.
The studies mentioned HPV (Human Papilloma Virus) and UV exposure plays a role in the formation of epidermal cyst.
How to change the epidermal cysts become cancerous is not known for certainly (though rarely epidermal cysts develop into malignant tumors). At epidermal cyst carcinoma, immunohistochemistry for HPV negative results, which can be summed HPV does not affect changes into squamous cell carcinoma. Chronic irritation and repetitive trauma to the limits of the cyst epithelium epidermis role in malignant transformation, but how to do is still unknown.
Histopathology
On histopathologic examination, epidermal cysts lined with stratified squamous epithelium containing granular layer. Laminated keratin found in cysts. Inflammatory responses can be found in the cysts rupture. Mature Cyst can be calcified.
TREATMENT
Generally, epidermal cysts do not require any treatment. When the excised can cause interference, or dissection entire cyst wall with incision. When part of the wall behind, the cyst may recur. Destruction of the cyst with curettage, liquid chemical, or electrodesiccation give unsatisfactory results.
When inflammation occurs, it can be given triamcinolone intralesional injection (amcort, aristocort) which can suppress PMN migration and make a narrow slit capillary blood vessels. Oral antibiotics are also given if necessary.
COMPLICATIONS
Very rare complications, including infection, scarring on removal, and recurrence. Malignancy in epidermal cysts are very rare.
