Atheroma – a cyst located in the skin oil glands resulting from difficulties or complete cessation of the outflow of secretion from it because of the obstruction of the external opening of its ductless. The secret to accumulate in the duct of the gland, stretches him, forming a gradually increasing cavity with oily contents, including detritus (dead organic matter), dead skin cells, fat and cholesterol crystals. Inside the atheroma sent by squamous epithelium.
Atheroma is the most common surgical disease of the appendages of the skin, it is equally common in persons both male and female.
Distinguish the true atheroma, developing of otservlist during embryonic development of epidermal cells and is a hereditary disorder, and false atheroma caused by blockage of the sebaceous gland duct, which causes the detachable accumulation in the lumen of the gland and the gradual formation of a baggie filled with atheromatous masses (modified sebum).
Causes of atheroma
The cause of atheroma may be a violation of metabolic processes resulting in a change in character of secretions (discharge) of the sebaceous glands, which leads to the obstruction of their ducts. Atheroma quite often appear for excessive sweating, which is particularly pronounced in the case of existing hormonal shifts, manifested fatty sebora and acne and creates an unfavorable atmosphere for the occurrence of cysts glands. Predisposing to the development of atheroma factors usually attributed to unfavourable environmental conditions and chronic trauma to the skin.
Symptoms of atheroma
Sebaceous cysts can be located on areas of the body rich in sebaceous glands, which include the scalp, face (especially below the line of the mouth), back of the neck, interscapular space, the area of the tailbone and the genitals.
Atheroma has the form of a subcutaneous soft rounded form, with clear boundaries and different sizes (from size of a pea to chicken eggs and even more). The atheroma covered with normal skin, being fixed in it. When viewed from atheroma in its center can be found clogged and enlarged duct of the sebaceous glands, through which in some cases can be allocated atheromatous mass. When palpating the atheroma, as a rule, painless and movable: moves together with the skin relatively deeper lying tissues.
Sebaceous cyst may remain small for years or to increase in size. Growing atheroma slowly, but when it reaches a large size (4-5 cm) may cause a cosmetic defect.
Originally arisen in the form of a small formation of spherical shape, the atheroma in the future is able to be opened and transformed into an ulcer. In some cases it can somawansa dense connective tissue capsule and remain in the form of a rather dense painless swelling of spherical shape.
Complications of atheroma
Quite often, especially with long-term existence of atheroma, suppuration occurs. This forms a subcutaneous abscess. Acute inflammatory process with festering atheroma leads to pain in the tumor area, hyperemia (redness) and swelling of the skin, and deterioration of the patient’s General condition, fever. Sometimes there is a spontaneous dissection festering atheroma, with her pus with an unpleasant smell.
Very rarely atheroma can degenerate into a malignant tumor.
Examination and laboratory diagnosis of atheroma
Treatment of atheroma
The main method of treatment of atheroma is a surgical operation which consists in removing the cyst under local anesthesia. Indication for excision of sebaceous cysts is its large size, and also the desire of the patient to achieve a cosmetic effect. Surgery can be performed in a clinic, however, significant size and complex atheroma localization, it is recommended hospitalization of the patient. The atheroma runs out along with the capsule that is the key to successful treatment. When not complicated course of atheroma following options surgery:
1. A skin incision is made over the place where the atheroma most acts. The contents of the atheroma is squeezed out, going cloth. Then the capsule of the cyst is grasped by the clamps and removed. Sometimes resorted to scraping cavity of the cyst with a special surgical instrument with a sharp spoon.
2. After incising the skin over the atheroma so that it will damage the capsule, the skin with sebaceous cysts shifted, then, by finger pressure on the wound edges, the husking of atheroma.
3. The most common method of surgical treatment is currently the next.
First, over the atheroma are two of the fringe section, covering the opening of the cyst. The edges of the skin incision are captured by surgical clamps. Simultaneously with careful pulling on the clamps under the atheroma summarizes jaws curved scissors, which is husking atheroma from the surrounding tissue. After wylosowane atheroma superimposed separate absorbable stitches thread in the subcutaneous tissue and the skin with vertical mattress sutures with a fine atraumatic threads, which are removed after 7 days.
Festering atheroma is an absolute indication for surgical intervention. It is often used only her autopsy to ensure churn out pus.
At the present time in connection with good cosmetic effect applies laser excision even festering atheroma under local infiltration anesthesia, which can be implemented using one of three methods:
1. Laser photocoagulation: is the total evaporation of the pathological focus within healthy tissue. It is used in cases when the diameter of atheroma in the period of suppuration does not exceed 0.5 cm. sutures after the laser photocoagulation is not required, the healing coagulation occurs under the crust, which is maintained from 7 to 15 days depending on the wound size.
2. Laser excision of sebaceous cysts along with the shell is used when the diameter of the festering atheroma from 0.5 cm to 2.0 cm and is reduced to the following: scalpel fusiform incision the skin is cut above the atheroma, while necessarily excised soldered the plot; the skin flap is taken on the holder, then use the laser beam is gradually released, the shell of the atheroma; the wound superimposed primary seams, left rubber drainage. Seams after laser excision shoot for 8-12 days after surgery.
3. Laser vaporization of the shell of the atheroma from within is used in cases, where the diameter festering atheroma more than 2.0 cm. the Technique is as follows: Opening atheroma is made with a scalpel through a small fusiform incision, necessarily excised soldered with the skin area. The purulent contents of the atheroma is removed by dry swabs of gauze. After that the edges of the surgical wound bred sharp hooks, when a laser beam shell of the atheroma evaporates from the inside. The wound superimposed primary seams, left rubber drainage. The sutures after the laser evaporation of the shell of the atheroma is removed from the inside 8-12 days after surgery.
Prevention of atheroma
For the prevention of atheroma is recommended to wash face with hot water and soap, while vigorously rubbing the skin hygienic sponge or wash cloth, hold steam bath, as well as to carry out the cleaning of the skin and rejuvenating massage.
Equally important is the exclusion of food containing large amounts of animal fats and carbohydrates.