Jabbour Samer, Kechichian Elio, Haber Roger, Tomb Roland, Nasr Marwan
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Saint Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
Department of Dermatology, Faculty of Medicine, Saint Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
Int J Dermatol. 2017 Jul;56(7):701-708. doi: 10.1111/ijd.13583. Epub 2017 Feb 27.
Digital mucous cysts (DMC) are benign, highly recurrent lesions of the digits. To date, there is still no treatment agreement on the treatment of DMC. Herein, we review available data on treatment modalities, including both surgical and nonsurgical techniques, and to provide a practical algorithm for the management of DMC. A systematic review was conducted using MEDLINE, EMBASE, and Cochrane databases. Articles studying the management of DMC were included in this review. A total of 40 articles were included in the review. The five most frequently used treatments for DMC were surgery (n = 849), expression of cyst content (n = 132), sclerotherapy (n = 119), corticosteroid injection (n = 108), and cryotherapy (n = 103). Surgery yielded the highest cure rate among all treatment modalities (95%) compared to sclerotherapy (77%), cryotherapy (72%), corticosteroid injection (61%), and expression of cyst content (39%) (P < 0.001). Surgery should be considered as the first-line treatment for DMC. Second-line treatments include sclerotherapy and cryotherapy. Third-line treatments include corticosteroid injections, expression of cyst content, and less-studied modalities. Surgery showed the highest cure rates. Future adequately designed randomized controlled trials are warranted to compare different treatment modalities.
指部黏液囊肿（DMC）是手指的良性、高复发性病变。迄今为止，对于DMC的治疗仍未达成治疗共识。在此，我们回顾了包括手术和非手术技术在内的治疗方式的现有数据，并提供了一种DMC管理的实用算法。使用MEDLINE、EMBASE和Cochrane数据库进行了系统评价。本综述纳入了研究DMC管理的文章。共有40篇文章被纳入综述。DMC最常用的五种治疗方法是手术（n = 849）、囊肿内容物挤出（n = 132）、硬化治疗（n = 119）、皮质类固醇注射（n = 108）和冷冻治疗（n = 103）。与硬化治疗（77%）、冷冻治疗（72%）、皮质类固醇注射（61%）和囊肿内容物挤出（39%）相比，手术在所有治疗方式中治愈率最高（95%）（P < 0.001）。手术应被视为DMC的一线治疗方法。二线治疗包括硬化治疗和冷冻治疗。三线治疗包括皮质类固醇注射、囊肿内容物挤出以及研究较少的治疗方式。手术显示出最高的治愈率。未来有必要进行充分设计的随机对照试验来比较不同的治疗方式。
