Ear atheroma is a retention cyst of the duct of the sebaceous gland located on the earlobe. Pathology occurs as a consequence of blockage of the excretory passage against the background of increased viscosity of fat secretion, injuries of the sebaceous glands or congenital anatomical features of their structure. Atheroma looks like a small nodule of flesh or pink color, which does not hurt, but is accompanied by aesthetic discomfort. Diagnosis of the disease is based on external examination and microscopy of the cyst contents in the postoperative period. Removal of the neoplasm is carried out by classical surgical, laser or radio wave method.
D23 Other benign skin neoplasms
Atheroma are recognized as one of the most common groups of benign neoplasms. They occur in 5-10% of the population, but the auricle is not the most typical localization for a sebaceous cyst. Most often, the tumor is located on the scalp, face or upper back. The peak of the diagnosis of ear atheroma occurs at a young age, women get sick more often than men. The relevance of the problem in practical dermatology is due to its frequent occurrence, a pronounced cosmetic defect and a tendency to suppuration.
The basis of the etiology of ear atheroma is a violation of the physiological process of secreting sebaceous secretions from the gland cavity to the skin surface or at the mouth of the hair follicle. The disease has a multifactorial nature, often one patient has several predisposing factors at once. The main reasons for the formation of atheroma are as follows:
- Changing the properties of sebum. An increase in viscosity and an increase in the production of fat masses provokes blockage of the excretory glandular ducts, promotes the formation of sebaceous plugs. This situation is observed with an increase in testosterone levels, the presence of fatty seborrhea, a tendency to acne formation.
- Injury of the sebaceous gland. Mechanical damage results in the formation of scar connective tissue, against which the excretory duct of the gland narrows or obliterates. Atheroma sometimes occurs in place of a healed abscess or boil, as a complication of unprofessionally performed ear piercing.
- Innate features. In pediatric dermatology, the appearance of retention cysts is associated with violations of the anatomical structure of the sebaceous glands. Hereditary factor and physiological hormonal fluctuations play a role in the development of the disease.
A cyst is formed when the sebaceous gland is blocked, as a result of which fat masses begin to accumulate in its cavity. At the same time, the secretion of sebum does not stop, the glandular secret collects inside the gland and stretches its walls. The growth of the neoplasm is not accompanied by compression of blood vessels or nerve endings, which explains the long-term asymptomatic course.
Histologically, the atheroma of the auricle is a dense connective tissue capsule, which is filled with exfoliated cells of the epidermis and the secret of the sebaceous gland. The contents of the cyst have a dense homogeneous consistency, a white or yellowish tint, a sharp smell of rancid fat. All cells have a normal structure without signs of atypia or malignancy.
The cyst of the sebaceous gland in most cases is detected by the patient accidentally when feeling the back surface of the earlobe. Women may notice atheroma when wearing earrings. The neoplasm feels like a small almost painless pimple, which is located inside the skin. From the outside, the cyst looks like a towering pinkish nodule with a light area in the center, so many people mistake it for an abscess.
Ear atheroma is not accompanied by painful sensations and does not cause any discomfort. The greatest concern in patients is caused by a cosmetic defect, therefore, if possible, they cover the neoplasm with hair. With mechanical action (putting on sweaters with a tight throat, wearing a medical mask with ear bands), the cyst begins to hurt and inflame.
Ear atheromas slowly increase in size and have no tendency to malignancy. The main problem of untreated cysts is the risk of infection with friction, accidental injury, and a sharp decrease in immunity. The reproduction of pathogenic microorganisms is manifested by swelling and redness of the earlobe, severe twitching or throbbing pains, the appearance of a purulent head on the surface of the skin.
Suspicious skin neoplasms require mandatory consultation with a dermatologist. During the initial examination, a nodule the size of a pea is found, which has a pinkish or flesh tint, causes unpleasant sensations in the case of bacterial inflammation. With large-sized atheromas, the earlobe is thickened and deformed. To confirm the diagnosis, the following methods are prescribed:
- Ultrasound of soft tissues. For large atheromas localized in the ear region, sonography is used. The study reveals a rounded formation with clear boundaries and homogeneous contents, which is surrounded by a dense capsule.
- Laboratory diagnostics. In preparation for surgical treatment, a hemogram, a coagulogram, and a standard biochemical blood test are performed. All patients undergo blood test for viral hepatitis B and C, syphilis, HIV infection.
- Histological examination. Microscopy of the removed biomaterial is prescribed to confirm the diagnosis. The detection of fatty masses and keratinized cells of epithelial origin makes it possible to exclude lipoma and other variants of tumors.
The disease has no pathognomonic symptoms, in appearance it resembles other variants of benign soft tissue neoplasms. Ear atheroma needs to be differentiated with the following tumors:
Differential diagnosis of a suppurated cyst is carried out with ear boils, pustules on the skin. In doubtful cases, the consultation of an oncologist, oncodermologist is required.
In order to rid a person of a cosmetic defect and prevent suppuration, a planned operation is recommended. Removal of ear atheroma is performed on an outpatient basis under local anesthesia, the procedure has minimal contraindications. The planned intervention is carried out in the traditional way using a scalpel or modern methods of laser and radio wave surgery. Minimally invasive technologies give the best aesthetic result.
With inflammation of the atheroma and the formation of a purulent focus, emergency surgical intervention is indicated. The task of the surgeon is to open and drain the sebaceous gland cavity, local administration of solutions of antibiotics and antiseptics. Postoperative wound management is performed according to the laws of purulent surgery with healing by the type of secondary tension. To prevent relapses of the disease, cyst removal is carried out after 3 months.
Medical treatment is carried out in addition to the surgical removal of the retention cyst. In the early period after surgery, the sutures are treated with antiseptic solutions, antibacterial ointments are applied. Wound-healing local remedies are also prescribed. In the first days after the removal of the atheroma, it is recommended to wear a sterile bandage that protects the tissues from injury and infection with bacteria.
Prognosis and prevention
Atheromas of the auricle have a favorable outcome, do not cause life-threatening complications and do not transform into a malignant tumor. The earlier the cyst is diagnosed and removed, the better cosmetic result can be achieved. Modern minimally invasive methods significantly increase the safety and effectiveness of the operation. Given the complexity and diversity of the etiopathogenesis of the disease, preventive measures have not been developed.