A 54-year-old woman developed an unsightly cyst on the nape of the neck which oozed cheesy material.

Epidermal cysts are very common and occur anywhere on the head and neck skin and at other sites. They are lined by stratified squamous epithelium and contain oily keratinous material.

Epidermal cysts are common skin lesions that can occur in various parts of the body, including the neck, face, and perineal area (Kang et al., 2011; Pawde & Kathale, 2014; Gupta et al., 2020). They are the most common cysts of the skin (Kang et al., 2011). In some cases, epidermal cysts can be associated with genetic syndromes such as Gardner’s syndrome, which is characterized by extraintestinal manifestations including dental abnormalities (Guilmette & Nosé, 2017). Dental abnormalities, including epidermal cysts, can also be seen in other inherited gastrointestinal cancer syndromes (Achatz et al., 2017). The treatment of choice for epidermal cysts is surgical excision, which is considered to be the first-line effective treatment (Suh et al., 2017; Yu et al., 2021). Epidermal cysts are typically benign, but rare cases of squamous cell carcinoma arising from an epidermal cyst have been reported (Al-Zawi et al., 2019).

References: Achatz, M., Porter, C., Brugières, L., Druker, H., Frebourg, T., Foulkes, W., … & Plon, S. (2017). Cancer Screening Recommendations and Clinical Management Of Inherited Gastrointestinal Cancer Syndromes In Childhood. Clinical Cancer Research, 13(23), e107-e114. https://doi.org/10.1158/1078-0432.ccr-17-0790 Al-Zawi, A., Memon, S., Shah, A., Eldruki, S., Tan, E., Alowami, S. (2019). A Squamous Cell Carcinoma Arising From Scrotal Epidermal Cyst. a Case Report And Review Of 94 Cases From The World Literature. Nowotwory Journal of Oncology, 3-4(69), 150-156. https://doi.org/10.5603/njo.2019.0028 Guilmette, J., Nosé, V. (2017). Hereditary and Familial Thyroid Tumours. Histopathology, 1(72), 70-81. https://doi.org/10.1111/his.13373 Gupta, R., Verma, P., Bansal, N., Semwal, T. (2020). A Case Of Ruptured Perineal Epidermal Cyst. Cureus. https://doi.org/10.7759/cureus.11099 Kang, S., Kim, C., Cho, H., Park, M., Lee, Y., Cho, M. (2011). Two Cases Of Giant Epidermal Cyst Occurring In the Neck. Ann Dermatol, Suppl 1(23), S135. https://doi.org/10.5021/ad.2011.23.s1.s135 Pawde, Y., Kathale, S. (2014). Fine Needle Aspiration Cytology As a Diagnostic Tool In Head And Neck Lesions. jemds, 45(3), 11072-11079. https://doi.org/10.14260/jemds/2014/3445 Suh, K., Kang, D., Park, J., Yang, M., Kim, J., Lee, K., … & Jang, M. (2017). Usefulness Of Dermoscopy In the Differential Diagnosis Of Ruptured And Unruptured Epidermal Cysts. Ann Dermatol, 1(29), 33. https://doi.org/10.5021/ad.2017.29.1.33 Yu, Q., Wang, Y., Shi, Y., Gu, J. (2021). A Rare Case Of Facial Multiple Epidermal Cysts: Successfully Treated By Surgical Excision.. https://doi.org/10.21203/rs.3.rs-892579/v1