Atheromas are usually called tumor-like formations that occur due to the blockage of the sebaceous gland, although other skin cysts of various etiologies also belong to this class of tumors. It is extremely rare, but skin atheroma can transform into a malignant tumor, so its timely diagnosis and treatment is very important for the patient's health. In addition, skin atheromas can be quite painful, carry the risk of infection, and therefore require careful attention from a dermatologist.
Atheroma of the skin gets its name from the Greek words meaning “swelling” and “gruel”, because it is a rounded formation in the form of a capsule filled with a thick yellowish or white mass with an unpleasant odor. This mass is the protein keratin, which is produced by the walls of the capsule. Atheroma of the skin is more common in middle-aged women, although it can also affect men. The reasons for its development have not yet been identified, although some scientists are inclined to the idea of hereditary predisposition.
Skin atheroma is considered a tumor-like formation, an epithelial cyst, which is formed as a result of blockage of the sebaceous gland – her excretory duct. Depending on the histological structure, these can be retention, epidermal, trichilemmal cysts, multiple steatocystomas, but they practically do not differ in their clinical manifestations, and therefore they are all called skin atheromas.
The main symptoms of skin atheroma and possible complications
Most often, atheroma of the skin occurs on the scalp, on the face, back and neck, in the inguinal region – where there are a large number of sebaceous glands. Blockage of the sebaceous gland is rarely a single formation, usually multiple skin atheromas – there may be more than ten in one patient.
At a doctor's appointment, patients complain of a tumor that has appeared under the skin, which can move under the finger and has a dense structure. The skin over the atheroma, as a rule, is not changed, but in case of inflammation it turns red, and with the rapid growth of the formation – ulcerates, and a point appears in the center where the blockage of the sebaceous gland occurred.
Atheroma of the skin may remain small throughout life or begin to grow in size, be under the skin or have an excretory duct to its surface.
The complication of the disease can occur when the focus of atheroma of the skin is injured, as well as with a decrease in immunity, non-compliance with personal hygiene, in patients with diabetes mellitus. In this case, suppuration of atheroma occurs, the skin turns red, swells, the focus of inflammation hurts and increases in size. If therapeutic measures are not taken in time, purulent inflammation can spread to surrounding tissues, and then abscesses and phlegmon development are likely. There is a rupture of a festering cyst in the subcutaneous tissue. Such complications of blockage of the sebaceous gland often leave rough scars after treatment. In addition, with a strong suppuration of the focus, it is not always possible to completely remove the skin atheroma capsule, and this can later provoke relapses of the disease.
To prevent severe complications of skin atheroma, all inflamed elements should be surgically sanitized – abscesses open and drain. Sometimes a course of antibiotics is prescribed to deal with the effects of inflammation.
Treatment of skin atheroma and features of postoperative rehabilitation
To treat atheroma of the skin is possible only by surgery, since the only way to get rid of blockage of the sebaceous gland is – remove the entire tumor along with the capsule in which it is enclosed.
When removing atheroma of the skin, local anesthesia is performed, then an incision is made over the tumor about 3 & mdash; 4 mm in size, through which either the entire tumor is husked without opening, or its contents are first removed and then the capsule itself (in this case, a minimal incision is needed). The incision is made along the lines of force and closed with a cosmetic suture or plaster. Methods for removing skin atheroma using biopsy instruments – above the atheroma, a round area of skin with a diameter of about 5 mm is removed and the capsule is removed, and then the wound is sutured.
Removal can be carried out with a scalpel, or with a radio wave knife or a laser beam. In the case of radio wave and laser exposure, the removal of skin atheroma occurs with little trauma, without bleeding (since the vessels are immediately sealed) and with a minimal risk of wound infection).
The result of the operation depends on whether the capsule is completely removed, whether the technique of the operation is observed, whether the wound is closed correctly, as well as on the characteristics of the patient's skin and compliance with postoperative recommendations not to wet the wound for two days, treat it daily with an antiseptic, protect it from traumatization.
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