What is the best treatment for folliculosebaceous cystic hamartoma (FSCM)?

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Last updated: March 4, 2025 • View editorial policy

From the Research

The best treatment for folliculosebaceous cystic hamartoma (FSCM) is complete surgical excision, as it provides definitive treatment and allows for histopathological examination to confirm the diagnosis, with minimal scarring and excellent prognosis 1. This approach is preferred because FSCM is a benign skin lesion composed of abnormal hair follicles, sebaceous glands, and mesenchymal elements that require complete removal to prevent regrowth. The procedure is usually performed under local anesthesia on an outpatient basis, with the size of the lesion determining the extent of the surgery. Some key points to consider when treating FSCM include:

  • Complete excision is necessary to prevent recurrence or continued growth
  • The procedure is typically performed under local anesthesia
  • Healing usually occurs within 1-2 weeks, depending on the size and location of the excision
  • The prognosis after complete surgical removal is excellent, with very low recurrence rates
  • FSCM can be misdiagnosed as other conditions, such as epidermal inclusion cysts, due to similar clinical presentations, but has distinct histological features 2, 3, 4, 5 It's worth noting that while there are various case reports of FSCM in different locations, such as the upper lip and labial mucosa 4 and genital area 5, the treatment approach remains the same. However, the most recent and highest quality study, published in 2024, supports the use of complete surgical excision as the standard treatment for FSCM 1.

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