Management of Infected Sebaceous Cyst on Scrotum
Assessment and Management
- For a resolving infected sebaceous cyst on the scrotum with no systemic symptoms, incision and drainage alone is typically sufficient, and systemic antibiotics are generally unnecessary unless there is extensive surrounding cellulitis or systemic signs of infection, as recommended by the Infectious Diseases Society of America 1, 2
- The patient presents with a resolving infected sebaceous cyst on the scrotum that has already spontaneously drained with no current discharge, mild induration, no fluctuance, and no scrotal erythema, which indicates a localized infection without systemic involvement 1, 2
- The American Academy of Dermatology recommends thorough evacuation of pus and probing the cavity to break up loculations for inflamed epidermoid cysts, often erroneously labeled "sebaceous cysts" 1, 4
- Systemic antibiotics should be reserved for cases with extensive surrounding cellulitis, severely impaired host defenses, systemic signs of infection, or multiple lesions or cutaneous gangrene, according to the Infectious Diseases Society of America 1, 2, 4, 5
- Overuse of antibiotics can contribute to antimicrobial resistance, as stated by the Infectious Diseases Society of America 2
Treatment Approach
- The most effective treatment for inflamed epidermoid cysts is thorough evacuation of pus and probing the cavity to break up loculations, followed by simple covering with a dry dressing, as recommended by the Infectious Diseases Society of America 1, 4
- Gram stain, culture, and systemic antibiotics are rarely necessary for uncomplicated, drained sebaceous cysts, according to the Infectious Diseases Society of America 1, 2