DIGITAL MUCOUS CYST

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Digital Mucous Cyst


Clinical

The DMC usually occurs in the periungual area. It often disrupts the nail matrix, making a groove in the skin. When punctured, a clear, viscous fluid may emanate. Fingers are more commonly affected than toes. The DMC is not a true cyst (with an epithelial wall). Instead, it is a pseudocyst.

Treatment

Initially, one should try repeated draining with a sterile needle. If three or so drainings fail, surgical excision may be done. For some lesions, there is a connection with the adjacent joint space. One report suggested using methylene blue injection to guide the surgery [BJD 1998;suppl 51;p. 72]. One study found intralesional photodynamic therapy to cure all 10 patients with just one session (mean follow up 10.5 months) [JAAD 2017;76;359].

Polidocanol sclerotherapy was performed on 63 patients with a DMC. The DMC contents were extruded and 3% polidocanol (0.02-0.5 mL) was injected to gently refill the cyst to its previous size. Subjects were reviewed after 6 weeks and offered a second treatment if necessary, and reviewed again after 12 weeks. 68.3% experienced complete resolution of the cyst by 6 weeks, and 77.8% experienced complete resolution by 12 weeks. Side effects were minor and had resolved in all patients by 12-week review [Dermatol Surg. 2016 Jan;42(1):59-62].

Additional Photos

Digital Mucous Cyst Digital Mucous Cyst
Digital Mucous Cyst Digital Mucous Cyst

DMCs often form grooves in the nail.
Digital Mucous Cyst Digital Mucous Cyst

Digital mucous cysts on the toes. In the first picture, the DMC has been punctured and a clear viscous gel has been expressed.
Digital Mucous Cyst Digital Mucous Cyst

Puncturing the DMC releases a thick viscous fluid.
Digital Mucous Cyst

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