A 67-year-old man sought medical attention because of the gradual development of a “lump” on his neck.
Key point: The nodule was smooth-surfaced, non-tender, somewhat compressible, and freely movable. The surface was slightly yellowish. This is both a typical location and appearance for an epidermal cyst.
Treatment: The patient was offered the option of elective excision. However, since the cyst had never caused any symptoms, the patient declined removal.
Note: An epidermal cyst that has never been inflamed or infected may well be removable though a very small punch biopsy followed by lateral pressure or a small linear incision. Cicatrix formation following inflammation or infection will usually result in more complex surgical intervention to achieve lesion removal.