A Digital Mucous Cyst (DMC) is a collection of mucin in the dermis, usually occurring between the proximal nail fold and the DIP joint.
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.
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. One study found intralesional photodynamic therapy to cure all 10 patients with just one session. Sclerotherapy with polidocanol has been used with success.
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