SKIN & SUBCUTANEOUS TUMORS.

1.DERMOID CYST.
Lined by Sq Epithelium.
Has Pultaceous tooth paste like material of Desquqmated epithelial Cells.
4 Types1,Sequestration.
2.Implantation.
3.Tublo Epidermoid.
4.Teratomatous.
1.Sequestration.
Congenital.
Inclusion of epithelium buried at thgevline of Embryonic Fusion.
Sq Epithelim,hair Follicles,Sebacious & Sweat glands.
Pasty pultaceous desquamated matrial with or witout Hair.
Mixture of Sebum,sweat &desquamated cells.
Sites-Midline-neck
Ext Angular bove the outer canthus of eye-fusio of Fronto Nasal& Maxillary
Process.
Post Auricular-Behind ear.
On the Skull at Fusion sites.
Midline- Root of the Nose.
Submental Dermoid.
PathologyFew Ectodermal cells get buried in the deeper Layer-Proliferate & Liquify.
Lie near to Mesoderm so Eodes deeper tiussue as Bones.
Can also originate in Mesodem & extend further Deep thru Bone into Skull.
CLINICALLY ;
Starts at birth but seen at later age.
No Symptoms.
Rarely Infected as got Thick Wall.
Slowly groth.
Cosmetic disfigurement as canbe large.
Ovoid/Sherical.
Smooth surface.
No punctum.
Soft /Indentable/Non Compressible or reducible.
Not fixed to kin.
BONY EROSION.
Non illuminate.
Can Have Intra Cranial Extension.
Inx ;
1.X-ray to see Bony erosion.

2.CT Scan if Deep. & fixed.

Complication.
Rarely- Infection,
Suppuration,
Ulceration.
Local Pressure effect.
TREATMENT.
Complete Exicision unde GA.
If a gap in te bine wait for the bone Suture to close.
If Intracranial deep- Osteoplastic Flap.
SUBMENTAL DERMOID ;
Sequestration dermoid .
Fusion of 1 & 2nd Branchial Arches.
ComplicationInfection/Ulceration /prone for Trauma /Cosmetic.
DD.;
1.submental Lymph node-septic foci.
2.Sebacious Cyst3.Suprahyoid Thyroglossal Cyst.
4.Ectopic Thyroid.
RxTotal Exicision.
2.IMPLANTATION DRMOID. ;
Acquired indriven Epithelium beneath the skin due to puncture injury-Needle/Thorn
prick.
Palm of Hand /Finger-Pulp-Tip/Sole.
Gardners,Talors /Female.
Lined bythik Sq epithelium containing White Cheesy Desquamated epi cells &Sebum but
no Hair.
Bygone Prick.
Painless Swelling.
Tense Cystic-Firm-Hard,
Globlar /scar +
Rx ;
Infection.
Suppuration
Rupture
Pressure Effect on Digital Nerves in Finger.
Rx ;
Exicision.

3.TUBULO DERMOID CYSTS.

Congenital unobliterated ectodermal ducts/tracts.
Lining Ectodermal cells of unobliterated ducts with Secretion
a.ThyroGlossal Cyst.
b.Post Anal Dermoid- remnant of Neuroenteric canal/Postanal gut-teratoma.
c.Ependymal Cyst of Brain.-infolded Neuroectoderm.
4.TERATOMATOUS DERMOID.
Cysts from totipotent cells of Ectodermal preponderance .Also contains mesodermal
Cells as Bone/Cartilage/Hairs/Tooth & Cheesy mayerial.
AT -Ovary.-Ovarian Cyst.
Testis Teratoma,
Mediastinum-mediastinal Cyst,
Retroperitoneal-Cyst,
Post Anal dermoid
SEBACIOUS CYST.
Sebacious glands in the skin secret Sebum to keep the skin soft & oily.
Duct opens into the Hair Follicle & rarely to skin.
If the duct opening is blocked it gets DISTENDED with own secretion ---SEBACIOUS
CYST RETENTION cyst-EPENDYMAL CYST ( lined by Superficial Sq cells)
Yellowish Pultaceous material of unpleasant smell.
In the Dermal level & extends ti subcutaneous plane.
Dermis Raised as Firm Elastic Dome shaped swelling.
Black punctum of Keratin plug
AT--Any where Except Palm/Sole.
Scalp/face/Neck/Shoulders/Chest/Abdomen/Scrotum
CLINICALLY ;
Any age-Young-old..Rare in Children.
Spherical few mm to 5 cm>
Smooth surface with Punctum.
Fixed to skin at Punctum.
SoftIndntable mouldable fluctant & movable in Skin if not infected.
In SCROTAL seb Cyst ;
Multiple,
Fells solid like Kachang,
Yellowish tallow & no Punctum.
DDLipoma/dermoid Cyst/neurofibroma/Fibroma.

COMPLICATIONS ;
1.Infection /Suppurtion can be repeatedly get infected.
2.Ulceration- bursts releases contents & covered by granulation tissue &
looks as Epithelioma.
In Skull lcertes & Excess granulation tissue will form &
Appears as Cocks Peculiar Tumor-angry & soreGranulation tossue arise from the epithelial cella Heaps upthru
Skin giving an everted edge.Infection becomes Edematous/
Red/tender & Lymph Nodes +
3.Sebacious Horn-slow discharge of sebum-gets dried hardens & hornifies.
4.Calcification-inScrotum.
5.Malignancy-BCC.
Rx;
Exicision.
Incision & Avulsion.
Wide Exicision & SSG.
Wide Exicision of Scrotual Skin/Srotectomy & Implantation of Testis in the Thighs.
LIPOMA.