Just Another Sebaceous Cyst?: I. Clinical Question

FELICIANO, JAESSA MAE D. PROF.
DHONNA CAMBE
BSN702 GROUP 5A EVIDENCE BASED NURSING
I. Clinical Question
What is the importance of formulating a differential diagnosis for sebaceous cysts?
II. Citation
Just another sebaceous cyst?
III. Study Characteristics
1 Patient
First patient was a 78-year-old man who had been treated with oral antibiotics for an
infected sebaceous cyst on the right lower back for a number of weeks. He presented to
accident and emergency with a painful, discharging lump on the back. The second patient
was A 23-year-old man with a 12-month history of a recurrently infected sebaceous cyst on
the right cheek.
2 Interventions Compared
The first patient had been diagnosed of an acutely infected sebaceous cyst after an accident
and was made by the on-call general surgical team because of the painful discharging lump
on his back. He was taken to the operation room for drainage of the abscess and samples
were taken for histopathology. The second patient had been prescribed several courses of
oral antibiotics because of his recurrent sebaceous cyst on the right cheek and it was called to
be useless. Hence, this made his doctor concerned and requested the patient to undergo a
clinical examination.
3 Comparison
Both patients were diagnosed incorrectly; both were diagnosed with just another
sebaceous cyst. In patient 1, the age of the patient would make a diagnosis of an
epidermoid cyst less likely. In addition, he had a significant history of skin cancer. On
examination, the lump in the back was immediately superior to the old melanoma
excision scar, which could have suggested an association between the two. Patient 2 in
case 2 was found to have a dental infection rather after the oral examination requested. A
diagnosis of a cutaneous odontogenic sinus was made and the patient referred to a
maxillo-facial surgeon for further management.
4 Outcomes Monitored
For patient 1, after histopathology was done, he was diagnosed with a late recurrence of
malignant melanoma. The true cause underlying late recurrence is uncertain. The skin and
subcutaneous tissue is a common site for metastasis of melanoma. These deposits can
become ulcerated and be painful. Ablation or excision is the treatment of choice to relieve
symptoms. For patient 2, oral examination revealed a grossly carious molar tooth that was
obviously neglected for 18 months. A diagnosis of a cutaneous odontogenic sinus
was made, which is a well-recognised, albeit uncommon, complication of a
dento-alveolar abscess.
5 Does the study focus on a significant problem in clinical practice?

Yes, because sometimes, not all diagnosis are made correctly. Therefore, correct treatment
and care are not done and met.
IV. Methodology / Design
1 Methodology used
The study was a Descriptive-Qualitative with detailed descriptions of specific situation(s)
using observations and document review; a case study concerning two people who were
diagnosed incorrectly. Both were given antibiotics and werent effective after long weeks of
medication treatment.
2 Design
The samples (patients) in the study concerns 2 people diagnosed with sebaceous cysts
incorrectly by medical doctors.
3 Setting
NOT MENTIONED
4 Data sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2121251/pdf/rcse8906-648h.pdf
V. Results of the Study

Two cases are presented where an incorrect diagnosis of a sebaceous cyst delayed the treatment
of a more serious underlying problem. The history and examination findings pointed to the
diagnosis in both cases. Although not rare entities in themselves, these cases illustrate the
importance of formulating a differential diagnosis even when confronted with an apparently
straightforward condition.
VI. Conclusion
Epidermoid cyst is the most common cutaneous cyst and is also commonly misdiagnosed with
other conditions, especially when on-the-spot diagnosis was made. On-the-spot diagnosis is
against the fundamental principle of the surgeonpatient consultation. Different diagnostics must
be done first before stating a final diagnosis to prevent wrong treatment to a particular condition.
VII. Recommendation
My recommendation is to seek for second opinion when disease condition is merely untreated for
a period of time. Second opinions can be sought for all sorts of conditions both minor and major.
Seeking for a second opinion is a good way to avoid a mistaken diagnosis, but the more likely
scenario is that you seek multiple opinions to help you decide on a course of treatment with the
best possible outcome and the best fit for your lifestyle and preferences.

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FELICIANO, JAESSA MAE D. PROF.

5 Does the study focus on a significant problem in clinical practice?

IV. Methodology / Design

V. Results of the Study

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