Cyst Management on the Forearm

Epidermoid Inclusion Cysts

Epidermoid inclusion cysts contain cheesy keratinous material and harbor normal skin flora even when uninflamed, according to the Clinical Infectious Diseases guidelines 1
Inflammation occurs as a reaction to cyst wall rupture and extrusion of contents into the dermis, rather than from primary infection, as noted by Clinical Infectious Diseases 1
Effective treatment requires incision, thorough evacuation of contents, probing the cavity to break up loculations, and covering with a dry dressing, as recommended by Clinical Infectious Diseases 1
Systemic antibiotics are rarely necessary unless complications exist, including multiple lesions, cutaneous gangrene, severely impaired host defenses, extensive surrounding cellulitis, or severe systemic manifestations like high fever, according to Clinical Infectious Diseases 1

Gram stain and culture are typically unnecessary, as stated by Clinical Infectious Diseases 1