Symptom >> Surgical >> Plastic Surgery

Skin adhesions

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Skin adhesions are common in skin cysts. It occurs at any age. In the youth, the head, arms and back are more common as a soft or soft or solid ball with a diameter ranging from 1 to 3 cm. The powder tumor is buried in the skin or subcutaneous tissue and adheres to the skin, and the substrate can be moved. When the skin surface shows that the small hole pushes the cyst, the adhesion to the skin is very tight here, and the small pit appears to be the opening of the catheter where the gland directly reaches the skin surface. Some of the openings are filled with a black acne-like peg to extrude white waxy material. It has many symptoms and is easy to be secondary to infection, and it is stinky and sorrowful. The literature reports cancerous changes, most of which are converted to basal cell carcinoma, and a few become squamous cell carcinomas with a cancer rate of about 2.2% to 4%.

Cause

Cause

Frequent in youth, often due to skin trauma, sometimes the incidence and trauma interval for many years or the injury is slightly difficult to recall.

Examine

an examination

Related inspection

Blood routine fungal histopathology

(1) Epidermal cyst: It is a kind of keratin cyst in the dermis. The epidermis is implanted into the skin due to trauma. The cyst wall is an epithelial structure, but the basal cell layer is the outer layer of the cystic wall. The stratum corneum is the inner layer of the cyst wall and is filled with keratin in the cavity.

The disease occurs in the scalp neck and hips and back. Single or multiple diameters ranging from a few millimeters to a few centimeters, slowly increasing, soft and hard, with a sac sexy base that can move and often adhere to the skin. There are no open pores on the surface of the skin like sebaceous glands without pain, such as compression pain when it occurs at the site of compression. The infection may be secondary to the possibility of malignant transformation.

(2) Dermoid cyst: often congenital lesions occur due to residual epithelial cells in the embryonic stage, which is a hamartoma, which is due to the fact that the skin cells that are deviated from the original form constitute a sweat gland, hair follicles and sebaceous glands. The cavity contains detached epithelial cells, sebace and other atheroma and hair.

Most of the patients with localized cystic masses found in young children and adolescents, slowly growing, small volume is a soft round or hard cystic mass. It is located under the skin, has no adhesion to the skin and adheres tightly to the basal tissue. It is not easy to push. It occurs in the nasal roots, occipital and oral base around the eyelids. Secondly, it is also seen in the chest and back of the limbs. The long-term growth can cause cancer.

(3) The sarcoma of the sebaceous gland is blocked by the occlusion or stenosis of the sebaceous gland, and the wall of the sebum is composed of epithelial cells. There is no keratinized image. The fibrous connective tissue is filled with sebum and gradually decomposed into semi-fluid substances. Contains a lot of cholesterol crystals.

Examination of skin cysts: Pathological biopsy can confirm the diagnosis.

Diagnosis

Differential diagnosis

Differential diagnosis of skin adhesions:

First, located in the dermis

1. a liquid cyst

Most of the female skin lesions in 40-50 years old occur in the dorsal side of the distal knuckles, more single. The size is about 3-15m, translucent, smooth: soft, the skin color cyst cavity is my fluid, which is scattered with stellate fibroblasts.

2. Millet rash

More common in women of any age, the cause of unknown is unknown; secondary occurs mostly in the treatment of sputum epidermolysis, congenital ectodermal defects, delayed skin dermatosis after skin grinding. Primary skin lesions occur in the eyelids and ankles; secondary lesions occur in the auricles of the hands and forearms. The size of the miliary is hard and hard, and the white sebum is seen.

3. Hair root sheath cyst

In the past, middle-aged women called sebaceous cysts were more common in the head, which was not easy to distinguish from epidermal cysts. The latter was common in the face and neck. The wall of the disease is composed of squamous epithelium, similar to the isthmus cells of the hair follicle. The content of the cavity is eosinophilic.

4. Multiple lipocytoma

Can occur in all ages for men and women. Skin lesions occur in the middle and lower part of the chest, and the scrotum can be single or multiple, showing a normal skin color or yellow, ranging from a few millimeters to 1-2 cm in diameter, and slightly smaller. The contents of the cavity are oily or cheese-like.

5. Epidermal cyst

More common occurs in young people, children, the elderly rarely seen in diameter 0.5-5cm, normal skin color, round elastic, slightly hard. The wall of the capsule is filled with keratin in the normal skin cavity. It can be single or multiple, often occurring on the scalp face, neck and trunk.

6. Bronchial origin and thyroid gland tube cysts are congenital dysplasia more common in the anterior or anterior neck of the sternum. Shortly after birth, more single lesions are less common, often accompanied by thin tubes. The performance of the two is similar to the composition of the pseudo-stratified columnar epithelium. It can be seen that the epithelial cells are ciliated in the human cyst.

7. Penile midline cyst: It is more common in young people and children. The lesion is located on the ventral side of the penis, especially the midline of the glans is about a few millimeters in diameter. The wall of the capsule is a pseudo-stratified epithelium, and some of the epithelial cytoplasm is transparent.

8. Eruptive hair loss cyst

More common in children and young people are small cystic cysts, the size is 1-2mm. The surface may have ecstasy and umbilical fossa common in the chest, and also visible in the limbs, the squamous epithelium of the posterior capsule wall, and the lamellar keratin and hair. The wall of the capsule forms a hair follicle-like structure.

Second, located in the subcutaneous tissue

1, skin-like cysts: there are many single hair after birth. Skin lesions are often located in the midline of the eye and the back of the face, which can occur everywhere on the body surface. The wall of no more than 2 cm in diameter consists of stratified squamous epithelium, but is different from epidermal cyst. The cyst cavity contains various epidermal appendages such as hair, and the hair follicles protrude into the human cavity.

2, chocolate cysts are also called "ovarian endometriosis", that is to say, this is the endometrium "run" into the ovarian tissue, and periodic bleeding with the uterus, these old blood, has become a cumulative The chocolate-like color is called a chocolate cyst.