Pathology

1. Dermoid cyst
   • Skin-lined cyst deep to the skin
   • May be congenital or acquired
2. Congenital: due to developemental inclusion of epidermis along lines of fusion of skin dermatomes therefore commonly found at:
   • medial and lateral ends of eyebrows
   • Midline of nose
   • Midline of neck and trunk
   • Suspect if you see a wee little toddler
3. Acquired
   • Due to forced implantation of skin into subcutaneous tissues following injury
   • Normally found in areas of body prone to injru such as fingers
   • Suspect if you see an adult in the exam

Approach

• Examine as for any lump

1. Inspect
   • Smooth spherical swelling
   • Look for associated scar from previous injury
2. Palpate
   • Soft
   • May fluctuate
   • Non-tender

Completion

1. How cyst affects life
2. Whether the patient has had a previous injury - if suspected acquired cyst 

Treatment

1. Congenital
   • Complete excision
   • Full extent of cyst should be established with suitable radiographic views
2. Acquired
   • Complete excision of cyst