Atheroma of the back code according to ICD. Photo of atheroma on the back: a harmless wen or a dangerous tumor? Conservative methods of therapy

Suppurating atheroma is a complication of a benign tumor of the sebaceous gland. The course of such a process varies. It can become inflamed, causing pain and even systemic fever. There is also a risk of atheroma rupture, which requires mandatory medical care. According to the international system of pathology classification, ICD 10 code L72.1 is assigned - trichodermal cyst.

How does the inflammatory process develop?

The entire human body, with the exception of the skin of the heels and palms, is covered with sebaceous glands. They are unevenly distributed. Most of them are on the face, scalp, back, and groin area. This is where atheromas form more often. Why is this happening?

As a result of non-compliance with hygiene rules, hormonal imbalance or excessive sweating, the duct of the sebaceous gland becomes clogged. The secretion begins to accumulate, forming cysts. Their size is different. Sometimes multiple rashes resembling small pimples are noted (this is called atheromatosis). In other cases, the tumor reaches the size of an average nut.

The secretion of the sebaceous glands is a complex mixture of lipids. They, in turn, serve as an excellent breeding ground for various microorganisms. After entering the cyst cavity, they actively multiply, causing inflammation. The causes of infection are:

• failure to comply with hygiene rules;
• an attempt to squeeze out atheroma, a person can do this deliberately or by mistake mistaking it for a pimple;
• excess secretion of testosterone in men or androgens in women;
• wearing tight synthetic clothing;
• skin injuries in the area where the wen is located.

Much less often, pathogenic microflora enters the bloodstream from other foci of infection. A similar picture is typical when the immune system is weakened due to chronic diseases. Doctors have different opinions regarding the likelihood of festering atheroma occurring. Some believe that if basic hygiene rules are observed, such a development can be avoided, others argue that inflammation will begin in any case. One way or another, if a lump appears on the skin, you should consult a dermatologist.

Clinical picture

Typically, atheroma looks like a spherical tumor located under the skin. In the absence of an infectious process, its color is no different from the surrounding tissues. When pressing it, a person does not experience pain. Discomfort may be associated with the location of the cyst. However, after inflammation occurs, the clinical picture changes, and the patient begins to complain of:

• sharp pain when pressing or touching the purulent atheroma;
• redness;
• at later stages, the duct of the sebaceous gland and the pus accumulated under the skin are clearly visible.

The further course of the process largely depends on the location of the inflamed cyst. Sometimes the infection spreads through the bloodstream to nearby lymph nodes. In this case, a sharp increase in body temperature, deterioration in general health, and the appearance of symptoms of intoxication are typical. In this case, in addition to removing the purulent atheroma, a course of treatment with antibacterial drugs is required.

Sometimes a cyst breaks through, releasing its contents, consisting of a mixture of fatty acids and pus, out. But the infection still remains in the cavity of the sebaceous gland, and sooner or later it will cause re-inflammation. Therefore, rupture of purulent atheroma requires certain therapeutic measures to be carried out at home. And then you need to see a doctor.

If a sebaceous gland cyst is suspected, the doctor makes a differential diagnosis of atheroma with other skin pathologies. If the wen is not inflamed, it is necessary to exclude lipoma, fibroma, lymphadenitis or granuloma. With concomitant infection, atheroma resembles a boil (a purulent process around the hair follicle). The final diagnosis is made after an ultrasound, which clearly shows a cyst cavity filled with pus.

Conservative methods of therapy

According to doctors, drug treatment of atheroma does not bring visible results. The only way to get rid of the tumor is surgery. Today, cosmetology clinics offer services for cyst removal with laser or electrocoagulation. But if the atheroma has begun to suppurate, these treatment methods are contraindicated, since it is impossible to determine the exact boundaries of the tumor capsule in such a situation.

Huge atheroma on the back

Wen (lipoma, atheroma), what is the difference, how to treat, cost of surgery

Removal of atheroma with capsule during suppuration

First, you should relieve inflammation and remove the source of infection from the sebaceous gland. For this, various antimicrobial solutions are used. Antibiotics are often required. After a course of antibiotic therapy, the doctor removes the tumor along with the capsule in any way convenient for the patient. The procedure for surgical treatment of suppurating atheroma occurs as follows:

1. The abscess is opened with a scalpel.
2. Remove the contents and wash the cyst cavity with antiseptic drugs.
3. A drainage is left in the wound; it is a rubber tube of small diameter. With its help, the sebaceous gland is regularly irrigated with antimicrobial solutions.
4. In parallel, the patient is prescribed a course of treatment with broad-spectrum antibiotics. The specific medicine is determined based on the general condition of the patient, age and the presence of contraindications.
5. After healing, the drainage is removed.
6. After 1–2 months, the cyst is removed under local anesthesia; schematic photos of the operation can be viewed on the websites of cosmetology clinics.

Treatment and removal of any festering atheroma is carried out in a hospital setting. The course of therapy may take up to two weeks. Of particular danger are foci of infection on the scalp (due to the close proximity of the brain), the area of ​​the external genital organs, and in the armpits (lymph nodes are located nearby). If symptoms of bacterial inflammation of a sebaceous gland tumor appear, you should contact your surgeon directly.

Possible complications

Not always, when atheroma suppurates, a person promptly seeks medical help to confirm the diagnosis and remove the cyst. In some cases, it ruptures. To prevent bacterial complications, you need to know what to do in such a situation. Doctors advise the following:

1. Carefully remove any pus that appears with a sterile bandage or swab.
2. Rinse the wound generously with chamomile decoction.
3. Treat the edges with an antiseptic solution (iodine or brilliant green).
4. Apply a sterile bandage.
5. Go to the nearest hospital for medical help.

It should be emphasized that if the sebaceous gland is festered, you should not use various ointments or creams. This can lead to further blockage of the duct and spread of the abscess to nearby tissue. Doctors emphasize that with severe suppuration, the risk of postoperative complications increases. The following signs indicate an incorrect course of the recovery period after removal of atheroma:

• increased body temperature;
• severe redness, swelling of the sutures;
• copious discharge of ichor from the wound mixed with pus;
• bleeding;
• divergence of seams.

This serves as a direct indication for reoperation. After it, pronounced cosmetic defects in the form of scars may remain. That is why dermatologists strongly advise removing atheroma without waiting for its inflammation and suppuration. Modern techniques allow this procedure to be carried out painlessly, without leaving visible traces of the operation on the skin.

To accurately define the disease and mutual understanding between doctors from different countries, the World Health Organization uses the International Classification of Diseases. The tenth revision of this document is presented in sections, where each pathology is listed under an alphanumeric code.

Skin diseases belong to class XII and occupy sections L00–L99. Atheroma, whose ICD-10 code is L72, in turn is represented by subsections L72.0–L72.9. Based on these data, medical professionals accurately determine the type of cystic neoplasm and receive information about its location.

Atheroma in ICD-10

Atheroma in ICD-10 refers to diseases of the skin and tissue. The pathology is directly related to the abnormal functioning of the sebaceous glands. Cyst-shaped neoplasms are equated to benign tumors, however, careless attitude and untimely treatment of the pathology can lead to serious consequences.

The occurrence of atheroma is caused by the accumulation and thickening of sebum in the sebaceous ducts. Externally, the neoplasm resembles an incipient pimple several millimeters in size, which tends to grow and can eventually grow up to 10 cm. Unlike other formations, atheroma does not cause pain or itching.

When palpating a tubercle with clearly defined boundaries, but not different in color from the rest of the skin, the presence of a solid body is felt under the skin, which easily moves within small limits. At first, a benign neoplasm causes inconvenience of a purely aesthetic nature. However, a frivolous attitude and untimely seeking of medical help often lead to serious consequences.

Knowing the atheroma code according to ICD-10, the doctor receives information about the nature of the pathology and the area of ​​​​the lesion. Based on these data, the further course of treatment is determined.

Classification of atheroma by localization

If we ignore the hereditary factor, in which atheroma is passed on to children from parents, the neoplasm can appear at any time and for a number of reasons. Moreover, it occurs much more often in adults than in children. A cystic tumor is characterized by places where sebaceous glands are present, that is, it can form on any part of a person’s skin - on the head, neck, back, groin area, under the arms and on the extremities.

Most often, atheroma affects the human head. This fact is due to the accumulation of sebaceous glands under the skin of this part of the body, which are most found on the scalp. The facial area is also susceptible to cystic neoplasm. Here the nose, cheeks, eyelids and chin are at risk. Pathology in these areas is especially troublesome because it is visible and disrupts the aesthetics of appearance.

Another common site of tumor growth is the skin in the area of ​​the auricle.

Ear atheroma is also associated with a large number of sebaceous glands, which provides extensive opportunities for its manifestation. In addition, an epidermal cyst is often present in the earlobe and makes itself felt only when it reaches an impressive size.

For the back, the risk zone includes its upper part, and usually the localization of atheroma is observed between the shoulder blades. Since this area is rarely examined, most patients do not even suspect the presence of pathology until a certain point.

According to the ICD code, the localization of atheroma is determined as follows:

• 0 informs about a cyst of the epidermal layer. This atheroma most often affects the face, neck, chest, back and scrotum;
• 1 indicates a trichodermal cyst. It is characterized by its location on the scalp, most often on the back of the head;
• 2 gives the concept of multiple steatocystoma, the manifestations of which are observed in the armpits, chest, hips, neck, scrotum;
• 8 reports data on other follicular cysts of the skin and subcutaneous tissue. They typically damage the skin of the central area of ​​the face, the corners of the eyes, the scalp and chest;
• 9 represents a follicular cellulose cyst under the skin. In this case, atheroma affects the ovaries.

Types of atheroma

The ICD code allows the doctor to determine the type of atheroma, each of which, in addition to location, has characteristic features.

Epidermal (epidermoid) cyst

According to the ICD code, this atheroma is designated L72.0. The most common type. It becomes the result of the formation of a capsule with an epidermal membrane containing clots of sebum. It has single, but sometimes multiple manifestations. The size ranges from 0.5 to 5 cm, in advanced cases it can reach 10 cm. The cyst grows with an increase in the level of keratin entering it. Most often it affects young and middle-aged people.

Also called a hair cyst or sebaceous cyst. According to the ICD it corresponds to code L72.1. Atheroma of this type is represented by a large multinodular tumor that is benign in nature. According to the name, it mainly affects the skin with a large accumulation of hair, i.e. head.

In its initial manifestation, it looks like a small pimple that does not cause itching or pain. As it grows, it hardens and takes the form of a mobile cystic tumor, covered with a layer of subcutaneous tissue. The neoplasm tends to ulcerate, become inflamed and suppurate. In some cases, it is accompanied by bleeding and death of nearby tissues.

Unlike the epidermal one, it lacks a central opening.

Multiple steatocystoma (sebocystomatosis)

Corresponds to ICD code L72.2. Presented with multiple cutaneous cystic nodules. Piercing the formations is accompanied by the release of fatty secretions. Typical for teenagers. It appears at the onset of puberty, but sometimes progresses after it.

Visually it resembles round tubercles with a yellowish color and dimensions not exceeding 4 mm. They are hard to the touch. Puncture of such neoplasms results in the release of a clear oily liquid.

Multiple steatocystoma does not have pronounced symptoms and is more problematic from the cosmetic side.

Other follicular cysts of the skin and subcutaneous tissue

This type includes atheromas classified by ICD code as L72.8. Such atheromas include:

• acanthoma, also called follicular infundibulum tumor. It appears on the face as irregularly shaped papules. Reaches large sizes. Most often present in a single copy. The cellular composition is similar to a trichilemmal cyst and basalioma, devoid of a stromal element;
• trichoepitheleoma is an atheroma associated with changes that occur in the epithelial membrane of the hair follicle. Solitary trichoepitheleoma is typical for females over 50 years of age. It is represented by a papule of about 2 cm, which increases with age and can reach 8–9 cm. Multiple trichoepitheleoma is manifested by a rash of papules, the size of which does not exceed 0.5 cm. It is observed in childhood and progresses over time;
• otrichoblastoma is extremely rare and is represented by primitive hair follicles and papillae.

Follicular cellulose cyst under the skin (unspecified)

It is also a follicular ovarian cyst, classified according to MBC as L72.9. It has no pronounced clinical manifestations. Symptoms and concomitant diseases are most often absent. It is studied on the basis of changes in menstrual cycles and diagnosed by identifying the delay of the latter. According to some data, it is accompanied by bleeding, according to others – amenorrhea.

With a follicular cyst of tissue under the skin, patients experience severe pain in the lower abdomen, which is caused by adhesions in the pelvis.

The most common and dangerous complication is twisting of the cyst stalk, followed by suppuration and peritonitis. The disease is often provoked by physical activity and can cause hemorrhage inside the cyst.

Although atheroma is not considered a life-threatening disease, it should not be taken lightly. Doctors recommend that if you have the slightest suspicion of a neoplasm, you should not delay visiting a medical facility. Only an experienced specialist can accurately diagnose the pathology and prescribe the necessary course of treatment.

An outpatient surgeon, and often a hospital specialist, often has to diagnose and treat patients with benign subcutaneous soft tissue tumors, Dupuytren's contracture, ganglion, neck cysts, keloids and ingrown toenails. Of particular importance is the diagnosis and determination of treatment tactics for malignant neoplasms of soft tissues.

Atheroma

Atheroma (ICD-10 code L72.1) is the most common surgical disease of the skin appendages, detected in areas of the skin rich in sebaceous glands (scalp, face, neck and coccyx area). The inner surface of the atheroma is lined with flat epithelium; detritus, keratinized epidermal cells, drops of fat, and cholesterol crystals are found in its cavity. Atheroma grows slowly and often suppurates. Treatment consists of surgical removal of the atheroma along with the capsule. Preservation of the capsule leads to relapse of the disease.

Pilomatrixoma

Pilomatrixoma (D14.0; synonym calcified epithelioma of Malherbe) is a single dense painless node up to 5 cm in diameter, yellowish in color, develops from cells of the hair matrix. Occurs on the face and hands, more often in young people. Differential diagnosis is carried out with a pilar cyst, hematoma, Spitz nevus. Surgical treatment is recommended - excision of the node with histological examination.

Lipoma

Lipoma (M8850/0, D17.9) is a benign tumor that develops from adipose tissue. Synonyms: wen, lipoblastoma. Lipoma is more often diagnosed in women aged 30 to 50 years; localized in the skin and subcutaneous tissue.

Lipoma is often multiple and sometimes develops symmetrically, which some authors explain by neurotrophic changes. The growth of lipoma is not related to the general condition of the body; Thus, when exhausted, they continue to accumulate fat.

Lipoma sometimes reaches large sizes. In these cases, the tumor sags, its base stretches into a thin stalk of skin ( lipoma pendulum), which creates conditions for blood stagnation, edema, necrosis and ulceration.

Macroscopically, the lipoma has a nodular shape - a node with a lobular structure is surrounded by a capsule. Less common is the so-called diffuse lipoma, with diffuse growths of adipose tissue devoid of a connective tissue capsule (in Dercum's disease and Madelung syndrome).

Atheroma is a cyst of the sebaceous gland, which is located under a thick layer of the epidermis. Here is a reminder that will be useful to practicing doctors and patients.

Atheroma (ICD-10 code D23) in adults is a benign formation inside the dermis.

It is represented by a round cavity formed by cells of the epidermis or hair follicle and filled with horny masses and the products of the sebaceous glands.

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The main thing in the article:

It can occur on any part of the body where there is hair, but is most often found on the scalp, face (especially on the chin), back, neck, and external genitalia.

The disease occurs with equal frequency in men and women. Atheroma is one of the most common surgical pathologies.

Atheromas tend to appear in places where the largest number of sebaceous glands are located. Tumors of this nature are diagnosed in the back, face, neck, and décolleté.

The causes of true atheroma are a failure in the development of skin appendages that occurred in the prenatal period, when the sebaceous glands are localized deeper than expected and do not have or have a poorly defined excretory duct.

Classification

Such a formation as skin atheroma has the following classification:

1. True atheroma. It is found in a newborn. It develops as a result of disruption of the development of germ cells of the epidermis; is a hereditary pathology.
2. Acquired atheroma (that is, a sebaceous gland cyst) is a formation that develops as a result of a violation of the outflow of the product produced by the gland. As a result, the discharge that it produces accumulates under the skin. The cavity of such a tumor gradually grows, because new secretions are constantly added to it, as well as epidermal cells, cholesterol, keratin, and drops of fat.

Treatment

The suppuration of existing atheroma on the body requires close attention. If a cyst is discovered, action must be taken to avoid worsening. To do this, do the following:

• You cannot open the tumor yourself.
• Call an ambulance if your general health worsens or if your body temperature is elevated.
• Do not self-medicate.
• Before going to the doctor, apply a clean gauze bandage to the area.

All attempts to use traditional treatment can lead to serious health problems and threaten life. If the treatment method is incorrect, the atheroma will continue to fester and therefore should be dealt with by a specialist.

To accurately diagnose the origin of the cyst, you need to make sure that it is not malignant. For this purpose, a sample is taken from a person for morphological and histological examination.

Treatment of formations that suppurate takes place in several stages:

1. Open the capsule.
2. Clean out the pus.
3. The cyst itself and the sebaceous duct canal are eliminated, which avoids relapse.
4. A tube is installed to allow unhindered washing of the wound and drainage of the contents.
5. Treatment is carried out with antiseptic agents and a bandage is applied.

In official medicine, it is possible to treat atheroma in men and women only by removal. Drug therapy for epidermal cysts is not prescribed.

The only case when a patient takes anti-inflammatory drugs is the spontaneous opening of an inflamed and suppurating atheroma. The surgeon removes the capsule of the cyst and cleanses the resulting wound from the remaining purulent masses, and the above medications relieve swelling and inflammation of the skin.

Medicine does not recognize treatment with folk remedies. Despite this, many resort to unconventional methods of getting rid of lipomas, atheromas and other tumor-like lumps on the body.

The most well-known methods are the following recipes:

Vishnevsky ointment

A compress of ointment is applied directly to the festering wound of the neoplasm and changed 2 times a day until the atheroma breaks through. The masses that come out should be carefully removed, and the wound should be disinfected from purulent fluid.

The root of the plant must be thoroughly washed, peeled and ground in a meat grinder. Burdock pulp is poured with alcohol or vodka 1:1. The root must be infused for 14 days and taken one tablespoon three times a day, after diluting the tincture with water.

Coltsfoot

The fresh leaf of the medicinal plant is washed and allowed to dry. Then you need to mash it so that the juice comes out. I apply the “cold” side to the pathological area, fix it and leave it overnight. The procedure must be repeated until the cyst goes away.

Half a medium-sized onion is baked in the oven and grated. A piece of laundry soap is also crushed to approximately the same size.

The ingredients are thoroughly mixed and the mass is applied to the tumor. The compress should be changed 3 times a day until the male or female tumor completely disappears.

Don't try to squeeze it out.

Grate a clove of garlic on the finest side of a grater and mix with a small amount of vegetable oil. This paste is rubbed into the growth several times a day.

These folk remedies can get rid of an epidermal cyst on the back, but do not forget that the remaining capsule under the skin can provoke a relapse. Turning to a specialist for professional help will get rid of the growth for life without the risk of re-formation.

Surgical removal of atheroma

Treatment of atheroma can only occur through surgery. If you treat a sebaceous cyst at home or with folk remedies, you can only slow down its growth, but not solve the problem.

Squeezing out the atheroma is contraindicated: it is a formation in the capsule, and emptying it of its contents will only lead to a temporary disappearance of symptoms.

Surgeries to remove atheroma are carried out as planned. Indications for emergency intervention are:

Treatment with folk remedies can be carried out in the absence of suppuration and inflammation of the atheroma.

Possible complications

Not always, when atheroma suppurates, a person promptly seeks medical help to confirm the diagnosis and remove the cyst. In some cases, it ruptures.

To prevent bacterial complications, you need to know what to do in such a situation. Doctors advise the following:.

1. Carefully remove any pus that appears with a sterile bandage or swab.
2. Rinse the wound generously with chamomile decoction.
3. Treat the edges with an antiseptic solution (iodine or brilliant green).
4. Apply a sterile bandage.
5. Go to the nearest hospital for medical help.

It should be emphasized that if the sebaceous gland is festered, you should not use various ointments or creams. This can lead to further blockage of the duct and spread of the abscess to nearby tissue.

Doctors emphasize that with severe suppuration, the risk of postoperative complications increases. The following signs indicate an incorrect course of the recovery period after removal of atheroma:

• increased body temperature;
• severe redness, swelling of the sutures;
• copious discharge of ichor from the wound mixed with pus;
• bleeding;
• divergence of seams.