Office management of digital mucous cysts.

Digital mucous cysts are solitary, clear, or flesh-colored nodules that develop on the dorsal digits between the distal interphalangeal joint and the proximal nail fold. There are two types of digital mucous cysts: one type is associated with degenerative changes in the distal interphalangeal joint, and the second type is independent of the joint and arises from metabolic derangement of fibroblasts that produce large quantities of hyaluronic acid. The two types are clinically indistinguishable. The cysts can be asymptomatic, or they can cause pain, tenderness, or deformity of the nail. Aggressive surgical techniques to remove osteophytes from the joint can produce low recurrence rates. Other procedures to eliminate cysts, such as a simple surgical technique, cryosurgical destruction, or repeated needling, can be performed in an office setting.