Inflamed Epidermal Inclusion Cyst on the Upper Back – A 67-Year-Old Female Case in Katy & Houston, Texas
by: Ashley Baldree
Case Overview
A 67-year-old female presented to Village Dermatology in Katy, Texas, with an inflamed, enlarging skin lesion on the left upper back. The lesion, present for approximately two weeks, was moderately painful, red, and swollen.
The patient reported a unique history — over 20 years ago, she sustained a thorn injury at the same location. She suspected that part of the thorn may still be embedded under the skin. Despite previous evaluations by other dermatologists, no definitive treatment had been provided.
Clinical Examination
Location: Left lateral upper back
Size: Approximately 2.5 cm
Appearance: Inflamed, tender, and erythematous lesion
Diagnostic tools: Dermatoscopic examination to assess lesion borders and skin changes
The findings were consistent with an inflamed epidermal inclusion cyst, likely exacerbated by localized irritation or possible infection.
Diagnosis
Epidermal Inclusion Cyst (L72.8)
Benign, non-cancerous growth consisting of keratin-filled sac beneath the skin
Current presentation complicated by inflammation and pain
Treatment Plan
The patient’s treatment plan included:
Antibiotic therapy – Doxycycline 100 mg by mouth twice daily for 14 days to address inflammation and potential secondary bacterial infection.
Definitive treatment – Cyst excision scheduled for the following week to remove the lesion entirely and prevent recurrence.
Skin care guidance – No special topical skin care required, but patient was advised to monitor for changes.
Patient Counseling
Epidermal inclusion cysts are benign and not cancerous.
They can become inflamed or infected, particularly if irritated.
Complete excision is the most effective long-term solution.
Warning signs of worsening inflammation include increased redness, swelling, drainage, or pain.
Dermatology Insight – Katy & Houston Focus
At Village Dermatology in Katy and Houston, Texas, we commonly treat epidermal inclusion cysts. While many are harmless and can be left alone, inflamed cysts often require antibiotics and eventual surgical removal. This case illustrates how early dermatology intervention can prevent worsening infection and recurrence.
