Steatocystoma Multiplex - Treatment

Treatment

The cysts can be moved via excision, though conventional cyst excision techniques have proven impractical, and a specialized regimen is required.

Medical treatments have been used with variable results to lessen inflammation, minimize scarring, and reduce the need for surgery.

Steatocystoma suppurativa: Treatment is indicated for this scarring inflammatory version of the disorder and involves antimicrobial therapy in combination with incision and drainage. The classic treatment is with the tetracycline class of antibiotics. Isotretinoin therapy has been effective in some patients; however, in others, it has caused the condition to flare. Recurrence following isotretinoin treatment has been reported.

Disfiguring lesions: The patient may require medical intervention for significantly deforming lesions when surgical approaches are impractical. Unfortunately, isotretinoin (despite its known effect of decreasing sebaceous gland activity) has shown inconsistent results. Flaring and recurrence following isotretinoin have been reported.

Cysts can be widespread and difficult to treat. A variety of surgical treatment options have been used in the treatment of steatocystoma multiplex.

Cryosurgery: Cryosurgery has been used in the past with limited success. Residual scarring limits this approach.

Aspiration: Simple aspiration with 18-gauge needle has been successful in minimizing scarring of facial lesions, although a high rate of recurrence has been observed. Variation of this method by insertion and gentle extirpation of cystic contents without removing the cyst wall has been shown to be successful, with no scarring and a low rate of recurrence. This technique is thought to be the treatment of choice in the management of facial lesions and those smaller than 1.5 cm in diameter. This approach may not be feasible with larger, more mature lesions with cyst contents of a more dense consistency.

Surgical excision: Traditionally, surgical excision is the most commonly mentioned method of treatment. Excisional surgery with elliptical excisions, flaps, or grafts is oftentimes impractical for widespread lesions and has fallen out of favor secondary to its time-consuming nature and the associated risk of scarring. Punch excision followed by cyst removal has been used in the past, with mixed results.

Incisional variants: Incisional variants of cyst removal have become the preferred methods of treatment. Mini-incisions of 1 mm with a No. 11 surgical blade followed by expression of cyst contents and excochleation of the cyst wall using a 1-mm curette resulted in minimal scarring and a low rate of recurrence. A modified surgical technique, used on more than 50 lesions, is sharp-tipped cautery followed by expression of cyst contents and forceps-assisted removal of the cyst wall. This technique resulted in minimal depressed scarring and slight hypopigmentation with no evidence of recurrence. Newer techniques with small incisions, 2-3 mm in length, followed by removal of the cyst wall with a phlebectomy hook resulted in satisfactory cosmesis, with no recurrence noted.

Carbon dioxide laser: Carbon dioxide laser ablation has allowed treatment of multiple lesions during a single treatment session, with no anesthesia, a low percentage of recurrence, and good aesthetic results.

Read more about this topic:  Steatocystoma Multiplex

Famous quotes containing the word treatment:

    The treatment of the incident of the assault upon the sailors of the Baltimore is so conciliatory and friendly that I am of the opinion that there is a good prospect that the differences growing out of that serious affair can now be adjusted upon terms satisfactory to this Government by the usual methods and without special powers from Congress.
    Benjamin Harrison (1833–1901)

    I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrongdoing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly, I will not give to a woman a pessary to cause abortion. I will keep pure and holy both my life and my art.
    Hippocrates (c. 460–c. 370 B.C.)

    Ambivalence reaches the level of schizophrenia in our treatment of violence among the young. Parents do not encourage violence, but neither do they take up arms against the industries which encourage it. Parents hide their eyes from the books and comics, slasher films, videos and lyrics which form the texture of an adolescent culture. While all successful societies have inhibited instinct, ours encourages it. Or at least we profess ourselves powerless to interfere with it.
    C. John Sommerville (20th century)