Atheroma: Description
Doctors refer to an atheroma as a “bump” surrounded by a layer of skin, which is mainly filled with skin cells and fat. Such filled cavities in the subcutaneous cell tissue, which develop due to a blocked gland, are also called retention cysts – in this case it is a trichilemmal cyst (“hair root sheath cyst”). Colloquially, the atheroma is also called a gruel pouch.
Differentiation from the epidermoid cyst
Occasionally, the so-called epidermoid cyst is also called an atheroma. These pea- to plum-sized nodules also develop from hair roots, but from their uppermost part (infundibulum). They contain mainly exfoliated horny material that is layered on top of each other. The “real” atheroma, on the other hand, is mainly filled with a very greasy substance.
Atheroma: symptoms
Atheromas are usually one to two centimeters in diameter. However, they can swell to the size of a chicken egg – in rare cases even to tennis ball size. In larger cysts, the skin that spans them is stretched apart considerably. This causes the hairs that grow here to stand further apart or be missing altogether. In some cases, a gray or black dot can be seen on the surface of the atheroma.
In the case of inflammation, the skin in the area of the atheroma reddens, it swells, and touch or light pressure cause pain. If pus also collects inside the atheroma capsule, it is an abscess.
Atheroma: Causes and risk factors
The excretory duct of the sebaceous gland can be blocked in a certain area, the so-called isthmus, for example by small fat crystals or skin cells. The sebum can then no longer flow out freely, but the gland continues to produce it. Gradually, the sebum accumulates and the hair root is pumped up into a round “bubble” – an atheroma develops.
Atheroma: examinations and diagnosis
Atheroma is usually diagnosed by a general practitioner or a dermatologist. During the initial consultation to obtain the patient’s medical history (anamnesis), he asks the person affected, for example, how long the cyst has existed, whether it causes him pain and whether there are or were other “lumps”.
Whether a “real” atheroma (trichilemmal cyst) or an epidermoid cyst is present can sometimes only be determined with certainty after the “bump” has been surgically removed and examined in the laboratory for fine tissue (histological). A histological examination is also important to clarify whether it is not perhaps a malignant growth.
Atheroma: Treatment
Remove atheroma
The dermatologist usually removes an atheroma on an outpatient basis under local anesthesia. During the procedure, the doctor takes care to cut away the atheroma together with its capsule and the associated excretory duct. If parts of it remain in the skin, there is a high risk that the atheroma will come back.
When the atheroma becomes inflamed
In the case of a bacterial infection, the atheroma swells, reddens, feels warm and hurts to the touch. If pus increasingly collects inside the cyst and cannot drain away, an abscess develops. This requires medical treatment in any case. Often, the doctor will then also use an antibiotic for treatment.
Atheroma: course of the disease and prognosis
In principle, after surgical removal of an atheroma, another atheroma can develop in the same place. However, if the procedure was performed professionally, the risk of this is low.
