65-Year-Old With Finger Growth

Differential Diagnosis

• Epidermoid cyst
• Ganglion cyst
• Glomus tumor
• Myxoid cyst

Diagnosis

The correct diagnosis in this case is a myxoid cyst—also known as a digital mucous cyst or pseudocyst. This is a ganglion cyst found on the distal interphalangeal joint of the finger or thumb, or less commonly, the toe. The cysts are believed to form from degeneration of connective tissue and often are associated with osteoarthritic joints. Skin biopsy histopathology will show a well-circumscribed superficial collection of dermal mucin without a true cyst lining. The overlying epidermis will be atrophic, hyperplastic or hyperkeratotic with a variable increase in fibroblasts and absent fibrous wall. 

What to Look For

• Myxoid cysts are more prevalent in women between the ages of 40 and 70 years.
• They are typically 3-10 mm in size, most commonly affect the second and third digits.
• While most are solitary, cysts may possibly appear in multiples.
• They are not painful or itchy.

Pearls for Urgent Care Management

• Myxoid cysts are benign, so no treatment is indicated
• If myxoid cysts become unsightly, cumbersome or painful, treatment is surgical excision

Download the Article PDF: 65-Year-Old With Finger Growth

Read More

• Assessment and Initial Care of Fingertip and Nailbed Injuries