Causes, symptoms and treatment of a wen
Zhirovik is a benign, painless formation with strictly delineated boundaries, enclosed in a capsule of connective tissue and consisting mainly of fat cells. Strictly speaking, the word "wen" in everyday life can mean a number of pathologies related in origin and symptoms: atheroma (cyst of the sebaceous gland), xanthelasma (flat yellow plaque on the eyelids), milium (tiny corneous cyst or "mildew"), but all it is usually called a lipoma. It is a soft, mobile neoplasm that has a lobular structure and is located in the subcutaneous loose tissues. Occasionally, a lipoma grows between muscles, vascular and nerve bundles up to the periosteum itself. Even less common is a spilled lipoma - a cluster-like accumulation of fatty masses, devoid of clear outlines.
Content:
- Causes of the appearance of a wen
- Are Wen a Danger?
- How to get rid of a wen yourself?
- How is a wen removed in the clinic?
- Fats in children
As a rule, adipose tissue is formed on areas of the body that are poor in lipid tissue: in the upper back, in the shoulder girdle, on the outer surface of the thighs and arms. Lipomas grow slowly, but over time they can reach gigantic sizes and cause significant discomfort, not to mention an aesthetic defect. In very rare cases, lipomas of the subcutaneous fat are transformed into liposarcomas - malignant tumors of the connective tissue.
Outwardly, the wen looks like a rounded or oval mound. When pressed, it easily shifts to the side, and the skin on its surface can gather in a fold. Such neoplasms are almost always isolated (94% of cases), but with some endocrine diseases, multiple wen on the body are diagnosed.
Classification of lipomas by localization and features of the internal structure:
- Subcutaneous (the most common and simplest type);
- Spilled (represents abnormally overgrown groups of lipid cells that do not have a capsule);
- Perineural (surrounds the nerves, very painful, difficult to remove);
- Intermuscular (grows between the muscles, often recurs with incomplete removal of the capsule);
- Myolipoma (formed in the thickness of muscle tissue, rarely subcutaneous);
- Angiolipoma (contains many vessels, most often localized in the kidneys, the subcutaneous type is almost never found);
- Adenolipoma (includes glandular tissue, often forms in the mammary glands);
- Lumbosacral (grows in the spinal canal, can squeeze the vertebrae, usually results from congenital underdevelopment);
- Periarticular (affects the synovial bags and tendons, causes pain and movement disorders).
The size of the wen varies from a match head to large tumors that compress nerves and blood vessels. If such large wen form on the limbs, they can significantly limit their mobility due to impaired blood supply and muscle activity. Large fats can also cause swelling and decreased sensitivity of the body area due to compression of nerve endings, vessels and soft tissues.
Since the wen grows very slowly, at the initial stage, the pathology can go unnoticed for a long time. The appearance of a lipoma is not accompanied by pain or a rise in body temperature. Occasionally, when a wen is localized in places of contact with clothing, skin irritation and hyperthermia may occur.
On palpation of a large wen, it is sometimes possible to reveal the heterogeneity of its structure, division into lobules. In some cases, lipomatosis is diagnosed - an accumulation of many small wen. This pathology most often manifests itself on the face, although it can be found on other parts of the body.
Fats formed on the eyelids, on the skin around the eyes are a cosmetic defect that does not lead to complications.
Causes of the appearance of a wen
Scientists-researchers of this problem consider the most accurate explanation of the nature of adipose tissue violation of metabolic processes. The leading role in the development of lipomas belongs to metabolic failure, namely, the lack of regulatory enzymes. The reason for this deficiency is the duplication of the long arm of the twelfth chromosome (12q13-15). There are loci of the gene responsible for the synthesis of TAG lipase. This enzyme is needed just in order to break down fats into energy and water.
That is, it has been proven that adipose tissue in humans does not grow due to the abundant accumulation of fats in adipocytes (adipose tissue cells), for example, as a result of overeating, but due to a violation of the lipolysis process. Congenital lipomatosis is inherited from parents in an autosomal dominant manner by children and usually manifests itself at a young age. Proof of the metabolic theory of the origin of lipomas is the fact that they are formed in people of any physique, not only in overweight.
Additional reasons for the appearance of wen:
- Diseases of the urinary system;
- Endocrine pathologies (hypothyroidism, diabetes mellitus);
- Hormonal imbalance.
Disruptions of metabolism in some cases occur due to excessive consumption of food with synthetic components. Additional risk factors are chronic tissue trauma by squeezing, vitamin and protein deficiency, and bad habits.
Are Wen a Danger?
Malignancy, or malignancy of a wen, is extremely rare, although such a danger should not be neglected. Much more often there is such a complication as the development of an inflammatory process in the capsule of the wen. It is formed when pathogenic bacteria enter the formation. The situation is complicated by the fact that protective antibodies are unable to penetrate the barrier created by the capsule around the wen.
When this capsule is pierced, an infection is introduced into it, the bacterial colony rapidly grows in an ideal environment for reproduction. At the same time, the volume of the wen can grow rapidly, edema and pain syndrome appear.
Painful sensations with an increase in the wen appear as a result of squeezing of soft tissues and nerve endings.
Video about the characteristic features of a wen, the causes of relapse and the risk of degeneration into a malignant tumor:
How to get rid of a wen yourself?
Self-removal of wen is unacceptable, piercing the formation capsule and squeezing out its contents can lead to negative consequences. Very often, a new tumor of an even larger volume soon appears at the site of a wen removed on its own, or suppuration, abscess, phlegmon develop.
Discomfort, a pronounced cosmetic defect, chronic irritation of the epidermis over the wen - the reason for its urgent removal in a medical institution.
How is a wen removed in the clinic?
A dermatologist or surgeon deals with the removal of wen. He skillfully diagnoses the type of formation and the factors contributing to its appearance, and will select the most appropriate method for enucleation of the defect in each specific case. To determine the cellular composition of the wen, the doctor may biopsy the contents of the capsule. Most often, this is an accumulation of fat, which looks like a dense yellow substance. With a very large size of the wen, an ultrasound scan is performed to clarify its structure and the volume of the affected tissues.
Indications for wen removal:
- Pronounced cosmetic defect, localization on the face and other open areas of the body;
- Accession of pain syndrome;
- Compression of the surrounding tissues, vessels, nerve endings by the capsule of the wen;
- Fast growth.
Removal methods:
- Drug destruction;
- Surgical excision;
- Laser or radio wave enucleation;
- Electrocoagulation.
Medication removal of wen is used in the case of small formations up to 1.5-2 cm in diameter. It consists in the introduction into the capsule of a solution that promotes the resorption of adipose tissue. After such an intervention, no scars remain on the skin. The pronounced effect of this procedure is noticeable no earlier than after 2-3 months. Drug destruction is ineffective in 20% of cases, that is, it does not give results at all.
With incomplete cleaning of the wound from parts of the capsule, the adipose tissue accumulates again and the wen re-forms. Modern surgical intervention, lasting less than an hour, will avoid relapses and complications, because not only the contents will be removed, but also the capsule of the wen.
Formations over 2-3 cm in diameter are removed by performing an operation under local or general anesthesia. After 1-2 days, the operated patient is discharged from the hospital and monitored on an outpatient basis for 10-14 days. After a certain period of time, an operation is prescribed to repair the scars left after the intervention, if necessary.
The innovative and most effective methods for removing wen are laser and radio wave surgery. For small neoplasms, electrocoagulation or vaporization of a wen is also relevant. All these operations are completely safe, they are performed under local anesthesia, do not take a lot of time, do not leave scars and do not lead to relapses.
Important: Do not postpone the elimination of wen on the face for a long time: they are removed without waiting for an increase in the formations. If the wen reaches a large size, it will be difficult to avoid scarring and scars after it has been eliminated.
Fats in children
The formation of a capsule with fat cells can occur not only in adults, but also in children of any age. Often, the removal of such defects is postponed until the child is 5 years old. In urgent cases, surgery is still performed. Indications for urgent removal of a wen in children are squeezing of the surrounding tissues with a rapidly growing formation, pain, discomfort, and inflammation. After the operation, histological examination of the removed structures is performed to look for atypical cells.
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.
