Sebaceous cysts are caused by blockage of the duct of the sebaceous gland, causing the gland to become distended by its own secretion of sebum. Clinically, sebaceous cysts present as movable, non-tender swellings under the skin, often with a visible punctum or opening. They are diagnosed through examination finding fluctuation and transillumination negativity. Treatment involves surgical removal by incising the cyst and expressing its contents. Complications can arise if the cyst becomes infected or ruptured.

1. Sebaceous Cyst

2. • Sebaceous glands
• Glands in the skin that secrete a lubricating
substance called sebum.
• Sebaceous glands either open into hair follicles or
discharge directly on to the skin surface.
• They are most numerous on the scalp, face, and
anus and are absent from the palms and soles of the
feet.
• Sebum production is partly controlled by androgen
hormones.

3. Sebaceous Cyst
• Cyst of the sebaceous gland due to blockage
of the duct of this gland.
• The gland becomes distended by its own
secretion(sebum).
• Sebum is thick paste like yellowish, white,
cheesy, pultaceous material.

4. Clinical features
• It is commonly seen in young adults, though no
age is exempt.
• It may occur anywhere in the body except palm
and sole, though it is commonly seen in the scalp,
face and scrotum.
• It may be single or multiple.

5. Clinical presentation
• Patients presents with complain of swelling.
• Almost always there is a black spot on the swelling, which is the obstructed
opening and is called punctum.
• This swellingis fixed to the skin but is quite movable over the deeper
structures.
• Sebum can be squeezed out from this cyst through the punctum.
• Sometimes punctum is not visible.

6. Examination
• It is smooth and of round shape whose margin yields to the palpating finger.
• Overlying skin cannot be pinched.
• Fluctuation test is always present.
• Transillumination test is always negative.
• Painless unless inflamed.

7. Management
• (A) Sebaceous cyst (1.5 to 2 cm).
• (B) Inject 1 mL of local anaesthetic over the top of the
cyst to form a wheal.
• (C) Incise with a No. 11 blade directly into the cyst.
• (D) Express the contents of the cyst.
• (E) Sebaceous material.
• (F) Grasp the sac with haemostats and tease it free with
gentle lateral pressure and a rocking motion.
• (G) Sebaceous material and appearance of wound after
removal. No closure is needed for a small incision.
• Surgical Removal(excision) only.

8. Complications
• Infection when the cyst becomes enlarged and painful.
• Rupture and sinus formation.
• Ulceration.
• Calcification.
• Carcinomatous changes.
• Sebaceous horn