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Vulvar Inclusion and Epidermal Cysts

by S. Gene McNeeley, MD

Vulvar inclusion cysts contain epithelial tissue; vulvar epidermal cysts develop from sebaceous glands. Both cysts eventually enlarge with cellular debris and sometimes become infected.

Inclusion cysts are the most common vulvar cysts; they may also occur in the vagina. They may result from trauma (eg, laceration, episiotomy repair) that entraps viable epithelial tissue below the surface, or they may develop spontaneously.

Epidermal cysts result from obstruction of sebaceous gland ducts.

Uninfected cysts are usually asymptomatic but occasionally cause irritation; they are white or yellow and usually < 1 cm. Infected cysts may be red and tender and cause dyspareunia.

Diagnosis is clinical.

Treatment, indicated only for symptomatic cysts, is excision. A local anesthetic can be used for a single lesion. For multiple lesions, regional or general anesthesia may be preferred.

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