ABSCESS AND SEBACEOUS CYST: WHAT'S THE DIFFERENCE

On a video uploaded by Dr Vikram Singh Yadav, I saw many people asking that what is the difference between abscess and sebaceous cyst. So I thought that I would create this post to explain you the difference between them. Ill come directly to the point here.

An abscess is cavity filled with pus. It occurs due to an unresolvable infection or inflammation which body, macrophages to be specific, cant kill or cant get rid off. So to prevent the spreading of the infection or inflammation our body tries to wall off the inflammation. This creates a cavity which is full of neutrophills and necrotic derbies. These present as painfull red warm swellings over various areas of body or at the injury site. An abscess could accompany with fever, lethargy and other constitutional symptoms.

Treatment of abscess is incision and drainage, betadine packing, noninflammatory drugs and antibiotics.

WHAT ARE THYROGLOSSAL CYSTS

Thyroglossal cysts are fibrous cysts that forms due to a persistent thyroglossal duct. The thyroid gland usually develops in the oropharynx and then it descends to its final position through tongue, hyoid bone and neck muscles making a thyroglossal duct which usually closes before birth. If it remains open it is called persistent thyroglossal duct which can lead to a thyroglosssal cyst formation.

Symptoms:

Usually patients present with palpable lump in the midline of neck between thyroid and hyoid bone which moves swallowing and upward with protrusion of neck. Usually the patients are asymptomatic but a few of them might complain of dysphagia i.e. difficulty in swallowing or he can present with difficulty in breathing. Sometimes cysts can get infected.

Treatment:

Surgical removal is the mainstay. Sistrunk operation is performed in which hyoid bone is also removed to ensure the complete thyroglossal tract removal to prevent recurrence.

WHAT IS PARONYCHIA

Paronychia is a bacterial or fungal infection of hand where nail meets the skin. It could start suddenly called acute paronychia or it gradually called chronic paronychia.. It is usually common in diabetics. Acute paronychia usually occurs in bacterial infection whereas fungal infection causes chronic paronychia.

Symptoms: Usually the first symptom is painful, red swelling around the nail, often at the cuticle or at the site of hangnail or other injuries. Pus filled blisters can also be found specially in bacterial infection.

Treatment: Paronychia can effectively be treated with antibiotics like cephalexin or dicloxacillin. Topical antibiotics can also be used. When there is pus in loculi we need to drain it. Sometimes partial nail is also removed.

                    Fungal infection tends to heal slowly taking a period of around 4-6 weeks.

Prevention: 

• Care for nail and and skin around the nail properly.
• Do not bite or pich the nai
• Protect nails from damage
• Bring your manicure tools.
• Avoid gatting damage to flaps.

WHAT IS STUDENTS ELBOW

Olecranon bursitis also known as student elbow is a condition in which there is pain, redness, swelling around the olecranon due to inflammation of the elbow bursa. The bursa is located on the extensor surface near the extreme proximal end of ulna.

CAUSES: It is usually caused by trauma to to the elbow like a hard blow to the elbow or repeated minor injuries to the elbow for example while studying. Due to the injury the bursa starts producing larger amount of fluid than normal exceeding the normal rate and gets accumulated in the bursa leading to swelling and pain.

Infection of bursa is also one of the cause.

TREATMENT: Usually the 1st treatment is rest and avoiding further injuries to the elbow.

Aspiration of the fluid and injecting steroid into the bursa to reduce inflammation is also one of the practices.

Antibiotics can be prescribed if inection is suspected.

Surgical resection of bursa can also be done if medical management fails.

Here is a video by Dr Vikram Singh Yadav of aspiration and steroid injection into the bursa.

PERCUTANEOUS NEPHROSTOMY VIDEO

Here is a video showing how PCN is done. Dr Vikram has explained it in the video very well. 

Indications for PCN are:

• Pelvi-Ureteric Junction Obstruction
• Renal abscesses, urinomas
• PUJ obstruction secondary to stone
• Urine diversion in obstruction during pregnancy
• Treatment regarding any fistulas due to iatrogenic or traumatic injuries, malignant or inflammatory fistulas.

Contra-Indications include:

• Bleeding diathesis
• Unco-operative patient
• Severe hyperkalemia (>7) -- Do dialysis first then the procedure

Urethral Stricture

It is abnormal narrowing of urethra due to trauma, STDs or urethritis.

Causes:-

• Inflammation or scar tissue formation due surgery, disease or injury
• Pressure from enlarging tumor
• instrumentation of urethra eg. cystoscopy
• STDs
• H/O repeated urethritis

Symptoms:-

• Decreased stream of urine
• Incomplete emptying of bladder with terminal dribling of urine
• Urinary intermittency
• Frequent micturition
• Acute or chronic retention of urine

Complications:-

• Urinary retention
• Bilateral hydronephrosis
• • Urinary infections
  • Urinary calculi

  Diagnosis:-
  
  
  • Urine routine examination with microscopy
  • Urine culture
  • Retrograde Urogram (RGU)
  • Post void residual urine
  • Cystoscopy

  Treatment:-
  
  
  • Instrumentation with bougies or catheter depending on severitySurgery eg urethrostomy or urethroplasty can be done

WHAT ARE SEBACEOUS CYSTS

A sebaceous cyst is closed sac under the skin filled with sebum which in a cheesy or oil like material. These cysts are sometimes called epidermal cysts. They are basically caused by blocked sebaceous gland, trauma, swollen sebaceous glands, excessive amounts of testosterone. Usually they present as painless nodule under the skin, can occur anywhere in the body. If they get infected, redness, pain, warm skin and tenderness appear around the area and cheesy like material may drain from the area.


How To Remove A Sebaceous Cyst by VideojugBeautyandStyle
 
Treatment usually include surgical removal of the cyst. If properly removed along with the wall and sac, cyst will not recur. If it gets infected, the cyst is 1st drained and patient is kept on antibiotic treatment. When infection gets settled the cyst is then excised.

This is a sebaceous cyst excised from back of patient

What Are Ganglion Cysts

Ganglion cysts are found most commonly at the dorsum of hand near the wrist joint or fingers. The can also be found near other joint. They are hard, somtimes painfull swellings, which on applying pressure move away, the movement is restricted on flexion/ extension of wrist, and on applying light the light is transmitted through the cyst as it contains clear fluid i.e. transillumination is positive.

Cyst usually resolves itself

Treatment options include aspiration and then injection with steroid e.g. triamcinolone (kenakort) or surgical excision. Although there is higher rate of recurrence.