Monday, October 29, 2007

VizD Challenge Week of 10/29/2007

A 37-year-old man presents to your Urgent Care clinic complaining of a painful lump to the back of his neck. He states the lesion has been there for more than 3 years but it has never been this painful. On your exam, the lesion is erythematous so you decide to perform an incision and drainage.


(click on image to enlarge)
Questions:
1. What is the name of this lesion?
2. What is the material that is released from the lesion after incision?
3. After the incision and drainage, does the lesion have a high or low likelihood of returning?



Winner receives $5!
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VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient. For more information please refer to the following link.

8 comments:

Anonymous said...

1) Sebaceous cyst

2) Sebum

3) High, if you do not remove the entire capsule and sometimes use packing so there is no dead space to fill up again.

JuliaMD, New York

jefferson said...

1. actinomycetes
2. sulfur
3. high likelihood

Anonymous said...

1. Sebaceous cyst
2. Sebum
3. High likelihood of returning (since the cyst wall is not removed but merely opened and drained).

Mike
mvankl@aol.com

iNeedParoxetine40mg said...

1. Cystic Hygroma
2. Clear, or yellow lymph.
3. Yes, recurrence is very common, unless other therapies considered. eg
-excision of large subcutaneous cisterns.
-cryotherapy, sclerotherapy, cautery.
-vaporisation with CO2 laser.
-hypertonic saline sclerotherapy.

taha said...

1-sebaceous cyst
2-sebum
3- completely removed cyst will not recur, though if the patient has a predisposition to cyst formation further cysts may develop in the same general area.

Brian and Jennifer said...

sebaceous cyst

high likelihood of returning if you don't properly excise it

jefferson said...

Thank you for hosting a very informative and interesting site.

jeff

Adam said...

I appreciate the warm comment - I hope you continue to visit.