Festering atheroma
Atheroma is a benign formation of the sebaceous gland. It is formed in case of blockage of the excretory duct, resulting in a cyst filled with detritus - sebum, particles of exfoliated epidermis. Since the gland does not stop functioning, the capsule is constantly enlarged. Its top rises above the skin surface, a pronounced cosmetic defect appears. Atheroma brings discomfort if it is constantly exposed to friction with clothing and mechanical pressure.
Content:
- How does inflammation occur?
- The clinical picture of suppurative atheroma
- Prognosis for the development of a festering cyst
- Diagnostics
- Treatment of suppurating atheroma
- Removal of education using laser surgery
- Post-operative care
How does inflammation occur?
Lipids accumulating in the cyst capsule are a breeding ground for the reproduction of pathogenic microorganisms. After entering the atheroma cavity, they multiply and thereby trigger the inflammatory process.
Reasons for infection:
- An attempt to independently get rid of atheroma, squeeze it out;
- Failure to comply with hygiene rules;
- Excessive production of testosterone by a man's body or androgens by a woman's body;
- The use of synthetic clothing and the resulting increased sweating;
- Injury of the epidermis in the projection of atheroma.
With weakened immunity, secondary infection can occur when pathogenic organisms enter the atheroma capsule with blood flow from other foci of infection.
The clinical picture of suppurative atheroma
If the infectious process does not complicate the development of atheroma, it looks like a rounded formation, raised above the skin. Its color differs from the color of the surrounding tissues by 1-2 shades; upon palpation, a person does not experience pain or negative sensations. At the apex of atheroma, you can sometimes find a black point - a clogged mouth of the cyst.
After suppuration and inflammation, the following symptoms appear:
- Hyperemia of tissues and their edema;
- Sharp pain when pressing on the inflamed formation, aching pain the rest of the time;
- An increase in the temperature of the skin surrounding the cyst;
- An increase in overall temperature;
- Increased atheroma in size;
- Symptoms of body intoxication with waste products of pathogenic bacteria (weakness, headache, nausea);
- Enlargement of nearby lymph nodes.
A long-lasting inflammatory process can lead to ulceration of atheroma. The formed crust can move away, and then the contents of the inflamed atheroma are visible under the skin. Sometimes the cyst opens spontaneously, its contents come out, the intensity of the symptoms decreases slightly. Nevertheless, the process of atheroma formation starts again. Relapse is facilitated by the fact that the cells of the capsule in which the cyst has formed give rise to the formation of a new formation.
Prognosis for the development of a festering cyst
Figuratively speaking, any atheroma, even if it is small in size, is a kind of "time bomb".
Any injury can damage the epidermis, and then the progressive inflammatory process forms the following complications:
- Abscess;
- Phlegmon, which forms a diffuse inflammation under the skin;
- Blood clot formation is a possible cause of death.
This means that at the first signs of inflammation of atheroma, you should seek the advice of a doctor. It could be a surgeon, a dermatologist.
Diagnostics
To diagnose atheroma, it is enough for the doctor to conduct a visual examination. It is important to differentiate atheroma from lipoma, hygroma, lymphadenitis or granuloma. In the stage of inflammation, an atheroma can easily be mistaken for a boil, inflammation of several small atheromas at the same time is a pustular rash, and ulceration is a syphilitic ulcer.
In difficult cases, an ultrasound examination of atheroma is performed, as a result of which an image of a cyst cavity filled with pus is obtained in the picture.
Treatment of suppurating atheroma
The only method of treating an inflamed formation is its radical removal with the help of surgical treatment. Despite the fact that modern methods such as laser and radio wave surgery are used to remove the sebaceous cyst, the inflamed atheroma is often removed in the traditional way using a conventional scalpel.
Removal of education takes place in 2 stages:
- Lancing of an abscess with removal of pus and remnants of the gland secretion;
- Removal of the capsule in which the atheroma is formed.
Between the stages, a course of treatment with antibacterial drugs prescribed by a doctor is carried out. Most often, modern effective antibiotics are prescribed: Sumamed, Azithromycin, Doxycycline, Lincomycin.
Opening and removal of the inflamed atheroma is carried out under local anesthesia. To do this, the doctor performing the manipulation performs several injections of anesthetic around the cyst. If it has reached a significant size, minor negative sensations may appear when it is removed.
Removal of the capsule of inflamed atheroma without damaging it is not always possible.
The operation is carried out in the following sequence:
- Two skin incisions are made around the atheroma;
- The skin flap over the cyst is removed;
- Surgical scissors are inserted under the cyst, separating it from the surrounding tissues;
- The highlighted capsule is pulled outward;
- A ligature is applied to the operating wound;
- After 5-8 days, the stitches are removed, measures are taken to regenerate the scar tissue.
Usually, after enucleation of a festering atheroma, a noticeable scar remains, to eliminate which it is necessary to do plastic surgery.
Removal of education using laser surgery
A laser knife is used to remove the inflamed and suppurating atheromas of a small size. Methods used in laser surgery:
- Photocoagulation - used to remove small inflamed atheromas (up to 5 mm). In this case, stitches are not required; after the postoperative scab has fallen off, after 1-2 weeks, a section of skin without damage remains under it.
- Excision of the cyst together with the capsule - used to remove formations 5-20 mm in diameter. First, an incision is made, then the capsule is separated from the surrounding tissues with a laser knife, evaporating the adhesion border with the surrounding structures. After the release of the atheroma, it is taken out, drainage is installed, the wound is sutured. After a few days, the drainage is removed, the stitches are removed after 1-1.5 weeks. As a result of this manipulation, an inconspicuous scar is formed.
- Vaporization (evaporation) of the capsule - used to remove atheroma over 20 mm in diameter. After opening the cyst and removing the contents from it, the surgical field is drained, the wound is stretched and the capsule shell is evaporated using a laser. At the end of the operation, a drainage tube is installed, and sutures are applied for 1-1.5 weeks.
After using a laser knife, an inconspicuous suture remains, the tissues surrounding the cyst are not injured.
Post-operative care
In order for the wound healing to proceed quickly and without complications, it is necessary to carry out regular dressings in a surgical hospital.
Possible care measures:
- Washing the wound with hydrogen peroxide;
- Applying ointment with antiseptic properties (Levomekol);
- Closing the wound with a sterile tissue.
After the edges of the wound have tightened somewhat and the sutures have been removed, you can apply BF-6 medical glue instead of a bandage. The glue is used within 15-20 days after removing the ligature.
The following signs indicate that wound healing proceeds with complications:
- Redness of the skin around the surgical wound;
- Temperature increase;
- Feverish condition;
- The appearance of purulent discharge from the wound, an admixture of pus and blood;
- Divergence of seams.
For any complication, you should immediately consult your doctor. If the removal was not carried out correctly, particles of the capsule remained, and atheroma may reappear. This complication occurs in 3% of cases and is corrected by a second operation.
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003, he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.
