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我们通常说的皮脂腺囊肿并不来源于皮脂腺!:皮脂腺囊肿成因和治疗

2022年04月18日 12694人阅读 返回文章列表

皮脂腺囊肿通常是缓慢生长的肿块,可移动。“皮脂腺囊肿”通常是指源自皮肤的表皮样囊肿,或来自毛囊的皮肤囊肿。理论上来说它们不是来源于皮脂腺的囊肿。“真的”来源于皮脂腺的囊肿较少见,此类囊肿囊腔中包含皮脂,它们是遗传性疾病,被称为单发性/多发性脂囊瘤。

多发性脂囊瘤

steatocystoma multiplex


皮脂腺囊肿的囊腔闭合,可以在整个身体的皮肤下找到(除了手掌和脚底),可能会散发出难闻的气味,其中充满了豆腐渣状物质,通常是无痛的。皮脂腺囊肿是皮肤常见的良性囊肿。它们生长缓慢并且不危及生命,但可能因为合并外伤或感染而给人带来不适。

皮脂腺囊肿

Sebaceous cyst



A sebaceous cyst usually is a slow-growing lump that can move easily under the skin. The term “sebaceous cyst” is commonly used to refer either an epidermoid cyst, which originates from the skin, or a pilar cyst, which comes from hair follicles. Therefore, technically they are not sebaceous cyst. ”True" sebaceous cysts, cysts which originate from sebaceous glands and which contain sebum, are relatively rare and are known as steatocystoma simplex or, if multiple, as steatocystoma multiplex.
Sebaceous cysts are closed sacs that can be found under the skin of the entire body (except the palms of the hands and soles of the feet). A foul odor may be noticed from the overlying skin. They are filled with cheese-like matter and usually are painless.Sebaceous cysts are common noncancerous cysts of the skin. They grow slowly and aren’t life-threatening, but they may become uncomfortable if they get infected or traumatized.


01

皮脂腺囊肿的成因是什么?

What are the causes of sebaceous cysts?

                                        
如果腺体或其导管(腺体分泌物能够离开的通道)被损坏或阻塞,则会形成囊肿。这通常是由于局部受外伤而发生的。

创伤可以是抓痕,手术伤口或皮肤疾病,例如痤疮。皮脂腺囊肿生长缓慢,因此创伤可能发生在您注意到囊肿之前数周或数月。
皮脂腺囊肿的其他原因可能包括:
 导管畸形或变形
 手术过程中细胞受损
 遗传疾病,如加德纳综合征或基底细胞痣综合征
Cysts can develop if the gland or its duct (the passage from which the secretion of gland is able to leave) becomes damaged or blocked. This usually occurs due to a trauma to the area.
The trauma may be a scratch, a surgical wound, or a skin condition, such as acne. Sebaceous cysts grow slowly, so the trauma may have occurred weeks or months before you notice the cyst.
Other causes of a sebaceous cyst may include:
 misshapen or deformed duct
 damage to the cells during a surgery
 genetic conditions, such as Gardner’s syndrome or basal cell nevus syndrome

02

皮脂腺囊肿的症状和表现有哪些?

Symptoms and Signs


体积小的囊肿通常不会疼痛。体积大的囊肿可能让人感到到不适甚至疼痛。面部和颈部的大囊肿可能会导致压力和疼痛。
皮脂腺囊肿通常充满白色角蛋白碎片,这也是构成您的皮肤和指甲的主要元素。大多数囊肿触感柔软,大小不同,通常为圆形。

Small cysts are typically not painful. Large cysts can range from uncomfortable to considerably painful. Large cysts on the face and neck may cause pressure and pain.
This type of cyst is typically filled with white flakes of keratin, which is also a key element that makes up your skin and nails. Most cysts are soft to the touch, vary in size, and are generally round in shape.


03

皮脂腺囊肿如何诊断?Diagnosis

通常,医生可以通过简单的皮肤检查来诊断皮脂腺囊肿。在某些情况下,医生会进行活检以排除其他诊断。如果您希望通过手术切除囊肿,您可能还需要这些检查:
√ CT扫描,帮助您的医生找到最佳手术方式并发现异常情况
√ 超声,识别囊肿的内容
Usually, a doctor can diagnose sebaceous cysts with a simple examination of the skin. In some cases, the doctor will perform a biopsy to rule out other skin growths. You may also need these tests if you wish to have the cyst surgically removed.
Common tests used for a sebaceous cyst include:
√ CT scans, which help your doctor find the best route for surgery and to spot abnormalities
√ ultrasounds, which identify the contents of the cyst



04

皮脂腺囊肿如何治疗?Treatment


皮脂腺囊肿通常不需要医学治疗。但是,如果它们继续生长,它们可能会影响外观,疼痛,感染或上者皆有。

Sebaceous cysts generally do not require medical treatment. However, if they continue to grow, they may become unsightly, painful, infected, or all of the above.

外科
手术切除皮脂腺囊肿是完全去除囊壁及其内容物的简单方法。有三种常用方法:传统的广泛切除法,小切口切除法和环切活检切除法。

不管使用哪种方法,手术关键点是完整移除囊壁和内容物,并对伤口进行冲洗、消毒,这样才能预防复发。

Surgical
Surgical excision of a sebaceous cyst is a simple procedure to completely remove the sac and its contents .There are three general approaches used: traditional wide excision, minimal excision, and punch biopsy excision.

No matter what method used, the key of surgery is to remove sac and content completely, then wash and sterilize the cavity before closing it. In this way, relapse can be prevented.
感染的囊肿在切除之前或之后可能需要口服抗生素或其他治疗。如果已经形成脓液,那么应该进行切开和引流、剥离囊壁并且运用适当的抗生素覆盖。


An infected cyst may require oral antibiotics or other treatment before or after excision. If pus has already formed then incision and drainage should be done along with avulsion of the cyst wall with proper antibiotics coverage.


下面是我团队进行的1例背部囊肿切除术:

龙X,男,25岁。背部肿块4年余,来我院就诊,上背部可扪及6 cm x 5.5 cm肿块,可触及活动囊壁。我们团队经过仔细检查,为患者制定了局麻下切除皮肤肿物的治疗方案。

Here is one of our cases of epidermoid cyst removal on the upper back.

Mr Long, male, 25 years old. He had the cyst growing on his back for over 4 years. He came to our hospital to seek treatment. A 6 cm x 5.5 cm movable lump with wall is palpable under the skin. After careful examination, we surgically removed the lump under local aneasthesia.

手术情况






张江林教授在皮脂腺囊肿的外科治疗方面有丰富的经验。得了上述疾病,莫惊慌,张江林教授团队为您保驾护航!

Professor Jianglin Zhang is highly experienced in the surgical treatment of sebaceous cysts.

If you have If you have one, don't panic! Prof

Zhang's team can help you get rid of it!



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