Successfully Nonsurgical Epidermoid Cyst Management with Recombinant Hydrolytic Enzymes: A Case Report

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-09 DOI:10.2147/ccid.s442955

Desiree Giselle Castelanich, Luis Alberto Parra Hernández, Maricarmen Chacín

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引用次数: 0

Abstract

Introduction: Epidermoid cysts (E.C.s), also known as sebaceous cysts, are benign asymptomatic subepidermal nodules filled with keratin material. These cysts originate from the follicular infundibulum, which when obstructed by keratin, results in cyst formation. Conventionally, E.C.s have been managed surgically with a high success rate and minimal complications. In this report, we present the successful resolution of an E.C. using a minimally invasive technique involving the intralesional injection of recombinant hydrolytic enzymes like hyaluronidase, collagenase, and lipase.
Case Presentation: A 44-year-old woman with no significant medical history presented to the clinic with a mass on her right cheek that had been evolving for over 10 years. Skin and soft tissue ultrasound confirmed the presence of an E.C. of 9.3× 6.6 × 9.3 mm. Owing to the size and location of the cyst, a decision was made to infiltrate the lesion with recombinant enzymes. Remarkably, significant clinical improvement was observed on Day 21, and complete dissolution of the E.C. occurred 40 days after the initial intervention. Importantly, no recurrences were observed during the 4-year follow-up period.
Conclusion: Intralesional administration of hydrolytic enzymes represents an innovative technique in the management of E.C.s. However, further controlled studies are required to determine the efficacy and safety of this procedure.

Keywords: epidermoid cyst, hyaluronidase, lipase, collagenase, sebaceous cyst

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用重组水解酶非手术成功治疗表皮样囊肿：病例报告

简介表皮样囊肿（E.C.s）又称皮脂腺囊肿，是一种无症状的表皮下良性结节，内含角蛋白物质。这些囊肿起源于毛囊基底膜，当其被角蛋白阻塞时，就会形成囊肿。传统上，E.C.都是通过手术治疗，成功率高，并发症少。在本报告中，我们介绍了利用微创技术成功解决 E.C.囊肿的方法，即在组织内注射重组水解酶，如透明质酸酶、胶原酶和脂肪酶：一名 44 岁的女性，无明显病史，因右侧脸颊肿块 10 多年来不断发展而就诊。皮肤和软组织超声波检查证实存在一个 9.3×6.6×9.3 毫米的 E.C.。鉴于囊肿的大小和位置，医生决定用重组酶浸润病灶。值得注意的是，第 21 天就观察到了明显的临床改善，在首次干预 40 天后，E.C.完全溶解。重要的是，在 4 年的随访期间没有发现复发：表皮样囊肿、透明质酸酶、脂肪酶、胶原酶、皮脂腺囊肿

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.