An Analysis of Surgical Results of Punch Incision and Elliptical Excision in Removal of Epidermal Cysts from the Head and Neck

Kwon, Tae Gwang; Son, Hyun Ho; Lee, Sook Kyung

Abstract

BACKGROUND
The removal of epidermal cysts from the head and neck can sometimes be challenging for dermatologists, due to the associated cosmetic effects. Punch incision is an alternative method to the traditional elliptical excision for the removal of epidermal cysts. It is simple to perform with commonly available instruments, and easy to learn. However, there is currently no randomized study directly comparing the long-term results of these two methods in Korea.
OBJECTIVE
The purpose of this study was to evaluate the usefulness of punch incision as compared to elliptical excision for the removal of epidermal cysts, and to identify the characteristics of the lesions most suitable for punch incision.
METHODS
We conducted a prospective randomized study. A total of 109 patients with non-infected epidermal cysts on the head and neck were randomly assigned to treatment with either punch incision or elliptical excision, between January 2012 and January 2013. Statistical analysis was performed to compare the differences between the two procedures with respect to the demographic data of the patients; size and location of the lesions; operative time; complications; recurrence; cosmetic results; and patient satisfaction.
RESULTS
The mean operative time for the punch incision group was significantly shorter than for the elliptical excision group (p<0.05). The cosmetic result scores at 6 months after the operation were significantly higher in the punch incision group, compared to the elliptical excision group (p<0.05). No significant differences were observed between the groups with regards to age, sex, disease duration, location, size, prevalence of complications, and recurrence rate (p>0.05).
CONCLUSION
Punch incision requires less time than elliptical excision, and is associated with superior cosmetic results. Regardless of different demographic characteristics, duration, location, and size, any epidermal cyst on the head and neck can be effectively treated with punch incision. Thus, we suggest that punch incision may be a useful method for removing epidermal cysts of the head and neck.