FELICIANO, JAESSA MAE D. PROF.

DHONNA CAMBE
BSN702 GROUP 5A EVIDENCE BASED NURSING

I. Clinical Question
What is the importance of formulating a differential diagnosis for sebaceous cysts?

II. Citation
Just another sebaceous cyst?
III. Study Characteristics

1 Patient
First patient was a 78-year-old man who had been treated with oral antibiotics for an
‘infected sebaceous cyst’ on the right lower back for a number of weeks. He presented to
accident and emergency with a painful, discharging lump on the back. The second patient
was A 23-year-old man with a 12-month history of a ‘recurrently infected sebaceous cyst’ on
the right cheek.

2 Interventions Compared
The first patient had been diagnosed of an acutely infected sebaceous cyst after an accident
and was made by the on-call general surgical team because of the painful discharging lump
on his back. He was taken to the operation room for drainage of the abscess and samples
were taken for histopathology. The second patient had been prescribed several courses of
oral antibiotics because of his recurrent sebaceous cyst on the right cheek and it was called to
be useless. Hence, this made his doctor concerned and requested the patient to undergo a
clinical examination.

3 Comparison
Both patients were diagnosed incorrectly; both were diagnosed with ‘just another
sebaceous cyst.’ In patient 1, the age of the patient would make a diagnosis of an
epidermoid cyst less likely. In addition, he had a significant history of skin cancer. On
examination, the lump in the back was immediately superior to the old melanoma
excision scar, which could have suggested an association between the two. Patient 2 in
case 2 was found to have a dental infection rather after the oral examination requested. A
diagnosis of a cutaneous odontogenic sinus was made and the patient referred to a
maxillo-facial surgeon for further management.

4 Outcomes Monitored

Therefore. Although not rare entities in themselves.nih. 2 Design The samples (patients) in the study concerns 2 people diagnosed with sebaceous cysts incorrectly by medical doctors. because sometimes. these cases illustrate the importance of formulating a differential diagnosis even when confronted with an apparently straightforward condition. not all diagnosis are made correctly. 3 Setting NOT MENTIONED 4 Data sources http://www.pdf V. Methodology / Design 1 Methodology used The study was a Descriptive-Qualitative with detailed descriptions of specific situation(s) using observations and document review. Results of the Study Two cases are presented where an incorrect diagnosis of a sebaceous cyst delayed the treatment of a more serious underlying problem. a case study concerning two people who were diagnosed incorrectly. 5 Does the study focus on a significant problem in clinical practice? Yes. These deposits can become ulcerated and be painful. he was diagnosed with a late recurrence of malignant melanoma. The skin and subcutaneous tissue is a common site for metastasis of melanoma. which is a well-recognised. oral examination revealed a grossly carious molar tooth that was obviously neglected for 18 months. . Ablation or excision is the treatment of choice to relieve symptoms.nlm. A diagnosis of a cutaneous odontogenic sinus was made. For patient 1. For patient 2. correct treatment and care are not done and met. The history and examination findings pointed to the diagnosis in both cases.gov/pmc/articles/PMC2121251/pdf/rcse8906-648h. after histopathology was done. IV. Both were given antibiotics and weren’t effective after long weeks of medication treatment.ncbi. complication of a dento-alveolar abscess. The true cause underlying late recurrence is uncertain. albeit uncommon.

Recommendation My recommendation is to seek for second opinion when disease condition is merely untreated for a period of time. but the more likely scenario is that you seek multiple opinions to help you decide on a course of treatment with the best possible outcome and the best fit for your lifestyle and preferences. Different diagnostics must be done first before stating a final diagnosis to prevent wrong treatment to a particular condition. . especially when on-the-spot diagnosis was made. VII. Seeking for a second opinion is a good way to avoid a mistaken diagnosis. On-the-spot diagnosis is against the fundamental principle of the surgeon–patient consultation.VI. Conclusion Epidermoid cyst is the most common cutaneous cyst and is also commonly misdiagnosed with other conditions. Second opinions can be sought for all sorts of conditions both minor and major.