From the Guidelines
Multiple epidermoid cysts on the labia are most likely caused by the blockage of hair follicles or sebaceous glands, leading to the accumulation of keratin and skin cells beneath the skin surface, and can be effectively managed with incision and drainage, without the need for Gram stain and culture, as recommended by the 2014 update by the Infectious Diseases Society of America 1. The causes of multiple epidermoid cysts on the labia can be multifactorial, including trauma or injury to the genital area, poor hygiene, hormonal changes, and genetic factors. Some key points to consider include:
- Trauma or injury to the genital area, such as from shaving, waxing, or friction from tight clothing, can contribute to cyst formation.
- Poor hygiene may also play a role by allowing bacteria to accumulate and infect hair follicles.
- Hormonal changes, particularly during puberty, pregnancy, or menopause, can increase sebum production and potentially lead to more cyst development.
- Some skin conditions like hidradenitis suppurativa can cause recurrent cysts in the genital region.
- Genetic factors may predispose some individuals to develop multiple cysts. According to the 2014 guidelines, incision and drainage is the recommended treatment for inflamed epidermoid cysts, carbuncles, abscesses, and large furuncles 1. Additionally, Gram stain and culture of pus from inflamed epidermoid cysts are not recommended 1, unless there are signs of systemic inflammatory response syndrome (SIRS) or markedly impaired host defenses. It is essential to note that these cysts are typically benign and not contagious, but if they become painful, infected, or cosmetically bothersome, medical evaluation is recommended. Maintaining good genital hygiene and avoiding trauma to the area can help prevent new cyst formation, as suggested by the practice guidelines for the diagnosis and management of skin and soft-tissue infections 1.
From the Research
Causes of Multiple Epidermoid Cysts on Labia
- Multiple epidermoid cysts on the labia can be caused by rare genetic disorders, such as Gardner and Lowe syndrome 2
- Trauma, as well as the imprisonment of epithelial rests during embryonic fusion, can also contribute to the development of epidermoid cysts 3
- Female genital mutilation (FGM) procedures or other traumatic events can lead to the development of epidermal cysts in the vulvar or clitoral region 4
Clinical Presentation and Diagnosis
- Epidermoid cysts are common benign lesions that can rarely occur on the vulva, including the labia minora 4
- They can be congenital or acquired and may cause discomfort or urinary obstruction when large 4
- Thorough clinical evaluation and imaging are crucial for accurate diagnosis and surgical planning 4
- Diagnosis of epidermoid cysts needs histopathological confirmation, not only to rule out the potential of malignant transformation 2
Treatment and Management
- The treatment of choice for epidermoid cysts is surgery, which can be performed under local anesthesia in most cases 2
- To avoid relapses, the cyst wall has to be removed completely 2
- Excision is often recommended, especially for large, symptomatic cysts, to manage the condition and obtain a definitive diagnosis 4