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Skin Care and Diseases

Inclusion cysts (sebaceous) spreading rapidly

07/27/2006

Question:

I have a condtion that has left about 7 dermatologists over 8 years stumped. I have inclusion cysts spreading all over my body. They began under and between my breasts and have since spread to my groin area, back, neck, and upper legs. I also have very soar bumps under my arms, but have been told that they are not the same thing (I think they are Hidradenitis?). I have had a colonoscopy (in 2004) and it came back negative for Gardner`s Syndrome... however everyone seems to still think I have it some how. I am a 27 year old female and the condition started when I was 17. I have done Acutane once, and been on every antibiotic and topical known to man. My questions: Is there anyway this could be cancer? Can Gardner`s Syndrom develop later in life? What other diseases could cause a Cystic disorder like this? Or, could this just be an acne issue that will go away with time (PLESE SAY YES)? Also, I think it is a hormone issue- but I don`t even know what type of doctor I should see to look into hormonal/Skin issues. Any help would be greatly appreciated.

Answer:

Your presentation is eloquent and certainly Gardner's Syndrome could be considered; but I remind you that Gardner's Syndrome is a syndrome.  While multiple cysts of various kinds can be part of that, there are more findings in the bones and bowel.  You appear to have only the cysts.  Are we certain that these are epidermoid cysts?  They might also be cystic structures such as steatocystoma multiplex.  If they have not been opened and their contents examined, I would suggest that that is the next step in working up the process.  You may wish to see a dermatologist that specializes in congenital abnormalities.  Most of those individuals can be consulted in Childrens' Hospital Medical Centers.  Most of these individuals, however, do have expanded practices and so could see you as an adult.  You might check the website of the American Academy of Dermatology (www.aad.org).  Once in this site look under pediatric dermatology and you will find the individuals who do specialize in genetic abnormalities.  It is time for the guessing game to stop, and I am sure you agree.  Good luck!

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati