BACKGROUND: Trichilemmal cysts are keratin-containing cysts, usually situated on the scalp. They often show an autosomal dominant inheritance pattern. Excision is the treatment of choice. We describe a practical surgical technique that eases the removal of these cysts. METHODS: A 24-year-old woman presented with a 5-year history of cystic lesions on her scalp, clinically diagnosed as trichilemmal cysts. She was treated with the new technique. After making a small incision under local anesthesia, a freer dissector (Aesculap(R) OL 165 R) was used as a blunt dissector. The freer dissector was inserted through the incision. A blunt dissection was made to dissect the cyst free from the surrounding dermis and, by using the dissector as a lever, gentle pressure was applied to the opposite side to ease the cyst from the dermis. Four cysts were removed with this technique. RESULTS: The treatment was well tolerated by the patient. No complications developed during or after the procedure. CONCLUSIONS: This modified technique is simple and practical. The slight curve at each end of the freer dissector makes it easy to grasp the cyst and, functioning like forceps, the cyst can be eased from the dermis. We believe that the use of the freer dissector in the surgical excision of trichilemmal cysts aids and speeds up the procedure.
BACKGROUND: Trichilemmal cysts are keratin-containing cysts, usually situated on the scalp. They often show an autosomal dominant inheritance pattern. Excision is the treatment of choice. We describe a practical surgical technique that eases the removal of these cysts. METHODS: A 24-year-old woman presented with a 5-year history of cystic lesions on her scalp, clinically diagnosed as trichilemmal cysts. She was treated with the new technique. After making a small incision under local anesthesia, a freer dissector (Aesculap(R) OL 165 R) was used as a blunt dissector. The freer dissector was inserted through the incision. A blunt dissection was made to dissect the cyst free from the surrounding dermis and, by using the dissector as a lever, gentle pressure was applied to the opposite side to ease the cyst from the dermis. Four cysts were removed with this technique. RESULTS: The treatment was well tolerated by the patient. No complications developed during or after the procedure. CONCLUSIONS: This modified technique is simple and practical. The slight curve at each end of the freer dissector makes it easy to grasp the cyst and, functioning like forceps, the cyst can be eased from the dermis. We believe that the use of the freer dissector in the surgical excision of trichilemmal cysts aids and speeds up the procedure.