Atheroma

Description:

The atheroma (from the Greek atheroma, athera — gruel and oma — a tumor) is the tumorous education relating to epithelial cysts of skin which are divided into several types depending on their histologic structure (a retentsionny sebocystoma of skin (it is formed as a result of obstruction of an output channel of gland), an epidermal cyst, a trikhilemmalny cyst, a multiple steatocystoma). On the clinical manifestations and treatment they are almost equivalent therefore in clinical practice they are called atheromas.

The atheroma represents the roundish education having the capsule and filled with the dense white or yellowish masses which often have an unpleasant smell. Contents of an atheroma is protein a keratin which is produced by its walls.

Atheroma reasons:

Atheromas occur at 5-10% of the population. They can be sporadic or hereditary (however, despite researches, it was not succeeded to reveal the genes responsible for emergence of atheromas yet). Meet at women more often, than at men, and also at people of middle age in comparison with young people.

Atheroma symptoms:

There can be on any body parts, however a preferential localization - head skin, faces, a back, necks, area of generative organs. On the head single atheromas meet in 30% of cases, multiple in 70%, and 10% of patients can have more than 10 atheromas.

Patients address with complaints to the tumorous education which is superficially located dense and elastic, usually well mobile (it is partially displaced when pressing by a finger), painless. Skin over education is most often not changed, but at an inflammation can be red color, and sometimes, at rapid growth, skin over an atheroma can ulcerate. In some cases on skin about the center of education the expanded obturirovanny output channel of a sebaceous gland is visible. The tumor can remain small for many years, or increase. Sometimes the atheroma is reported with the surface of skin through a small opening through which curdled white or yellowish masses, usually with an unpleasant smell can separate.

The differential diagnosis is carried out with tumors of soft tissues (fibroma, a lipoma, dermoid cysts, an osteoma).

Complications:

Atheromas often suppurate, at the same time erubescence, pain in the field of a tumor appears, swelled or increase it in sizes. The suppurated atheroma, in the absence of treatment, can break spontaneously outside, at the same time pus with saloobrazny contents and an unpleasant smell is emitted. Spread of an infection on surrounding fabrics with development of phlegmon is also possible. At suppuration the urgent surgical intervention consisting in opening and drainage of an abscess is required. Cosmetic results of such intervention it is much worse than planned operations as the skin section at the same time is not taken in, and heals second intention with formation of a rough hem. Besides, in the conditions of purulent fusion it is not always possible to remove completely the atheroma capsule that can lead to a recurrent tumor further. In some cases it is necessary to apply antibiotics.

Rare complication of an atheroma is its injury at which there can be a rupture of a cyst in hypodermic cellulose or outside that too demands urgent surgical treatment. Extremely seldom the atheroma can be transformed to a malignant new growth.

Treatment of an atheroma:

Method of treatment of atheromas – only removal of all tumor together with the capsule in the surgical way. In one international administration of other methods of treatment it is not described.

Usually operation is carried out under a local anesthesia (lidocaine or novocaine). There are several ways of removal of atheromas, an obligatory element of each of them is removal of the site of skin connected with a tumor and full removal of all capsule of a tumor. Most often the atheroma is deleted, carrying out a section over a tumor and or enucleate a tumor without opening of its gleam, or take the capsule after removal of contents of a tumor (for the purpose of reduction of the size of a skin section). The minimum section from which it is possible to remove an atheroma of 3-4 mm. In the West removal of atheromas by means of biopsy tools by means of which delete the round site of skin over an atheroma with a diameter of 3-5 mm with the subsequent extraction of the capsule is widespread. The wound then is taken in. Seams are removed for 7-10 day after intervention. The patient is forbidden to wet the field of operation within 48 hours, it is necessary to process daily a wound betadiny or other antiseptic agent. On the head the bandage on a wound is not necessary in most cases, on other body parts usually it is required bandages as there is a friction of a wound about clothes. At localization of a tumor in the field of a pilar part of the head a small amount of hair is cut off, usually it is no more, than the tumor size so in most cases the fact that operation is performed, on people around not considerably.

There is a wish to disseminate the existing delusions concerning removal of atheromas without surgical intervention. Removal of an atheroma by means of laser or radio wave (what we do in our clinic) a scalpel is a surgical intervention, same, as well as traditional operation by a usual scalpel and other surgical instruments. At intervention it is necessary to remove the atheroma capsule, and without skin section it cannot be made. Besides the atheroma is connected with skin therefore at an oncotomy its separation from skin is necessary. The accurate and minimum short skin section executed in the right direction (along power lines of skin) and closed then by a cosmetic seam or a special plaster begins to live equally well whether it is executed by an acute scalpel or a radio wave knife. The laser and a radio wave scalpel help to remove the capsule from surrounding fabrics with the minimum injury and bleeding.

Thus, the atheroma (a trikhodermalny cyst) is deleted only surgically in the way, by means of surgical instruments and (it is possible, how accessory instrument) the laser or a radio wave scalpel. Advertizing of removal of atheromas without operation – is unfair. Radicalism (lack of a recurrence) is provided with full removal of the capsule. The cosmetic result is provided not by(with) the tool (the laser or radio waves), but the correct technology of operation and the correct sewing up or closing of a wound, and also specific features of skin of the patient.