From the Research
A myxoid cyst is a small, benign, fluid-filled growth that typically appears on the fingers near the nail bed, most commonly on the last joint of the finger, and is also known as a digital mucous cyst or ganglion cyst of the distal interphalangeal joint. These cysts contain a clear, jelly-like substance called mucin and usually develop due to degeneration of connective tissue or from a connection to the nearby joint 1. Myxoid cysts are more common in middle-aged and older adults, particularly women, and are often associated with osteoarthritis. They typically appear as smooth, round, firm bumps that may be skin-colored, bluish, or translucent. While usually painless, they can cause nail deformities if they press on the nail matrix.
Key Characteristics
- Benign, fluid-filled growth
- Typically appears on the fingers near the nail bed
- Contains a clear, jelly-like substance called mucin
- Usually develops due to degeneration of connective tissue or from a connection to the nearby joint
- More common in middle-aged and older adults, particularly women
- Often associated with osteoarthritis
Treatment Options
- Observation for asymptomatic cysts
- Drainage (though recurrence is common)
- Cryotherapy
- Steroid injections
- Surgical removal for persistent or problematic cysts
- The underlying joint connection must be addressed during treatment to prevent recurrence 2.
Diagnosis
Dermoscopy is a non-invasive imaging technique that allows accurate diagnosis of the digital myxoid cyst, facilitating identification of telangiectasias, reddish-violet lagoons, ulceration, and a bright-whitish reticulum 1. Differential diagnosis mainly includes ganglion, Heberden's nodes associated with osteoarthritis, glomus tumors, and dermatofibromas.
Management
Treatment options range from observation to surgical intervention, with reported healing rates of 95% for surgical excision 1. Sclerotherapy, cryotherapy, CO2 laser vaporization, infrared coagulation, caustic elimination, and manual compression of the cyst can also be used. Within non-surgical measures, sclerotherapy has reported a 77% healing rate, followed by cryotherapy (72%), corticosteroid injections (61%), and manual compression (39%) 1, 3, 4, 5.