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Dermoid Cysts

Checked: 23-11-2022 by Rob Adams Next Review: 23-11-2023

Overview

A dermoid cyst is a developmental cyst resulting from inclusion of embryonic epithelium at sites of embryonic fusion. Unlike epidermoid cysts, dermoid cysts contain various adnexal structures (hair, sebaceous, eccrine or apocrine glands) and, rarely, other tissues such as bone, teeth and nerves (1).

Please see PCDS for further advice on recognition and management:

Dermoid cyst (pcds.org.uk)

Other features:

Often present at birth, nearly all present before the age of five years
Predominantly they occur on the head and neck area
Untreated, dermoid cysts persist and may later grow
They may have deep connections and so if lesions need to be excised the patient should be referred.
It is sometimes necessary to perform imaging prior to surgery to find out the extent of the lesion eg midline tumours of the face can have intra-cranial connections and those of the back intra-spinal connections

Referral

Suspected dermoid cysts in babies and children under the age of 5 should be referred to paediatric dermatology via eRS for a diagnostic opinion and excision if required. Referral is not subject to prior approval or EFR as these are not considered benign skin lesions.

Suspected dermoid cysts in older children and adults can be sent for USS and/or should be photographed and an opinion obtained from either:

Paediatric dermatology advice and guidance (patients aged under 16 yo)

Adult dermatology advice and guidance (patients aged 16 and over).

If a referral is recommended following imaging or A and G then this can be made via eRS without prior approval/EFR.

(1) Dermoid cyst (pcds.org.uk)

(2) Dermoid cysts | DermNet (dermnetnz.org)

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