I have just seen a patient with the above for the 3rd time. She is a healthy active(runs 6miles/week) 60yr old with no s/s of PAD.
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Visit 1 - Tense cyst 10mm diam - pierced with sterile needle and paste extruded
Visit 2 (10 weeks later) Pt reported that cyst had "settled down" but was concerned about the blood blister that had formed over it. I debrided the 10mm lesion to reveal extravasated paste. Sample taken for C&S. Hardened silver nitrate applied to base of cyst.
Visit 3 (5 weeks later). "It's not uncomfortable any more, but I would just like it to go". Now 6mm diam, shallow lesion debrided to reveal healthy base which is still extruding some paste from a 2mm central area. C&S from visit 2 revealed only skin flora. I applied hardened silver nitrate again.
If this doesn't resolve it I'm thinking a spot of phenol under a ring block would probably do the trick. Has anyone else experience in treating this kind of lesion? I've been prone to cysts myself and know what a nuisance/worry they can be.
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