Treatment of digital myxoid cysts with infrared coagulation: a retrospective case series.

BACKGROUND

Digital myxoid cysts (DMC) are often unsightly; they may cause nail dystrophy and are sometimes painful. There is a multitude of existing therapies and recurrences are not uncommon; some treatments may be painful or result in scarring. Infrared coagulation (IRC) produces predictable thermal injury with relative sparing of superficial tissues and represents an alternative treatment modality in DMC.

OBJECTIVES

To assess the outcome of treatment of DMC with IRC.

METHODS

Twenty-two patients with DMC treated with IRC were identified retrospectively (23 DMC: 18 finger and five toe). IRC was delivered to the area of the cyst under local anaesthesia.

RESULTS

Of the 23 lesions treated with IRC 86% responded; these included 73% that resolved after a single treatment, one lesion that relapsed after 3 years, one lesion that was reduced in size and one lesion that required three treatments over 18 months but has not recurred over the subsequent 9 years. There were three early recurrences that required treatment with other modalities: two were successfully treated with surgery and one responded to a single treatment with cryotherapy. One patient was excluded from the analysis because it was not possible to assess her adequately.

CONCLUSIONS

We present long-term follow-up data (mean follow-up 4.8 years, range 10 months-10.5 years) of the treatment of DMC with IRC. Treatment was well tolerated, with few side-effects, and cosmetic outcome was excellent. While recurrence rates were similar to many existing therapies, the ease of delivery, tolerability and cosmetic results make IRC a favourable option for the treatment of DMC.