Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


#Sebaceous Cysts.#--Atheromatous cysts or wens are formed in relation to
the sebaceous glands and hair follicles. They are commonly met with in
adults, on the scalp (Fig. 99), face, neck, back, and external genitals.
Sometimes they are multiple, and they may be met with in several members
of the same family. They are smooth, rounded, or discoid cysts, varying
in size from a split-pea to a Tangerine orange. In consistence they are
firm and elastic, or fluctuating, and are incorporated with the
overlying skin, but movable on the deeper structures. The orifice of the
partly blocked sebaceous follicle is sometimes visible, and the contents
of the cyst can be squeezed through the opening. The wall of the cyst is
composed of a connective-tissue capsule lined by stratified squamous
epithelium. The contents consist of accumulated epithelial cells, and
are at first dry and pearly white in appearance, but as a result of
fatty degeneration they break down into a greyish-yellow pultaceous and
semi-fluid material having a peculiar stale odour. It is probable that
the decomposition of the contents is the result of the presence of
bacteria, and that from the surgical point of view they should be
regarded as infective. A sebaceous cyst may remain indefinitely without
change, or may slowly increase in size, the skin over it becoming
stretched and closely adherent to the cyst wall as a result of friction
and pressure. The contents may ooze from the orifice of the duct and dry
on the skin surface, leading to the formation of a sebaceous horn
(Fig. 100). As a result of injury the cyst may undergo sudden
enlargement from haemorrhage into its interior.

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