Epidermoid cysts are asymptomatic, dome-shaped lesions that often arise from a
ruptured pilosebaceous follicle. The minimal excision technique for epidermoid
cyst removal is less invasive than complete surgical excision and does not require
suture closure. The procedure is easy to learn, and most physicians experienced
in skin surgery can perform the procedure after three to five precepted sessions.
It involves making a 2- to 3-mm incision, expressing the cyst contents through
compression and extracting the cyst wall through the incision. Gauze or a splatter
shield should be used to protect the physician from spraying of cyst contents.
The rarity of associated cancer makes histologic evaluation necessary only if
unusual findings or clinical suspicion of cancer is present. Inflamed cysts are difficult
to excise, and it is often preferable to postpone excision until inflammation