Comprehensive Dermatologic Care for Scalp Lesion, Lentigines, Cherry Angiomas, and Seborrheic Dermatitis in a 41-Year-Old Female
At Village Dermatology in Katy, Texas and Houston, Texas, we treat a wide range of skin conditions with both medical expertise and patient-focused care. This case highlights a 41-year-old female patient returning for follow-up after treatment for an inflamed epidermal inclusion cyst on her left thigh. Her visit evolved into a comprehensive dermatologic assessment addressing multiple skin concerns.
1. Follow-Up After Inflamed Epidermal Inclusion Cyst
The patient previously underwent incision and drainage, and pathology confirmed the diagnosis of an epidermal inclusion cyst — a benign growth composed of keratin. At her follow-up visit, the surgical site had healed well, with no signs of recurrence. She was reassured about the benign nature of the cyst and educated on monitoring for any new changes.
2. Evaluation of Scalp Lesion – Neoplasm of Uncertain Behavior
During the visit, the patient expressed concern about a darkly pigmented lesion on the left central parietal scalp. Clinical examination revealed a macule with differential diagnoses including neoplasm of uncertain behavior, blue nevus, or pilar cyst. We recommended a biopsy for definitive diagnosis. The patient opted to schedule the procedure for a later date, and we emphasized the importance of early evaluation for any lesion that changes in size, color, or shape.
3. Lentigines – Sun-Induced Pigmentation
The patient also presented with lentigines, or sun spots. She was counseled on strict sun protection, including the daily use of a broad-spectrum SPF 30+ sunscreen, sun-protective clothing, and reapplication during extended sun exposure. Cosmetic treatment options, such as topical retinoids, chemical peels, and laser therapy, were reviewed.
4. Cherry Angiomas – Benign Vascular Growths
Several cherry angiomas were noted on the mid-back and periumbilical area. These bright red vascular spots are harmless but can be treated with laser or electrodesiccation for cosmetic reasons. The patient was reassured and given information on removal options.
5. Seborrheic Dermatitis – Chronic Scalp Condition
The patient also reported scalp flaking consistent with seborrheic dermatitis. She was prescribed ketoconazole 2% shampoo for maintenance and flare control, along with fluocinonide 0.05% topical solution for short-term use during flares. We educated her on the chronic, relapsing nature of seborrheic dermatitis and discussed how stress and weather changes can trigger symptoms.
Patient Education and Next Steps
Biopsy: Strongly recommended for scalp lesion to rule out malignancy.
Sun Protection: Continue SPF 30+ use and avoid peak sun hours.
Scalp Care: Use medicated shampoo weekly for maintenance; topical steroid for flares.
Skin Surveillance: Monitor for new or changing lesions, and return promptly for evaluation.
At Village Dermatology, we prioritize both accurate diagnosis and individualized treatment plans, ensuring patients have the knowledge and tools to maintain healthy skin year-round.
