An epidermoid cyst, also known as an epidermal inclusion cyst or a sebaceous cyst, is a semisolid cyst. The cyst wall is stratified squamous epithelium, and the contents consist of macerated keratin and lipid-rich debris. Epidermoid cysts are commonly occurring lesions that can arise on the scalp, face, trunk, extremities, in the mouth, or on the genitals at any age, although they are most common in adults. They are also more common in men.

Several etiologic factors have been implicated in the formation of epidermoid cysts, including traumatic or iatrogenic implantation of epidermal elements, sequestration of epidermal rests, occlusion of the eccrine duct or pilosebaceous unit, and human papillomavirus (HPV) infection. Smoking may contribute to the development of multiple epidermoid cysts on the face. Epidermoid cysts are a feature of several hereditary syndromes, such as Gardner syndrome, pachyonychia congenita, and the basal cell nevus syndrome.

Epidermoid cysts are benign and usually asymptomatic, but they may be painful if ruptured or infected. Rarely, malignancies such as basal cell carcinoma, squamous cell carcinoma, and mycosis fungoides have developed within these cysts.

Pediatric Patient Considerations:
It is rare to see an epidermoid cyst in a prepubertal patient; in such cases, other diagnoses should be carefully considered.