Myxoid cyst

• Digital myxoid pseudocyst:

  Also called:

  • Mucous cyst
  • Digital ganglion cyst
  • Digital synovial cyst
• What is a digital myxoid pseudocyst:

  • Shiny papule found at the end of a finger or toe, close to the nail
  • Called a pseudocyst because it is not surrounded by a capsule unlike a true cyst
• Causes:

  • Arise from degeneration in the connective tissue on the top of the last segment of the finger, 2 variations:

  1. Form of focal mucinosis - abnormal deposits of mucopolysaccharides (mucins) in the skin
  2. Extension of the lining of the finger joint due to osteoarthritis - a type of ganglion
• Clinical features:

  • Semi-translucent
  • Smooth shiny surface
  • Most often located within a centimetre of the base of the nail - often causes a groove in the nail
  • Jelly-like sticky fluid may be expressed from the pseudocyst (sometimes tinged with blood)
• Treatment:

  • Repeatedly pressing firmly on the cyst
  • Squeezing out its contents (make hole with a sterile needle)
  • Cryotherapy
  • Steroid infection
  • Sclerosant injection - chemical solution injected causing sclerosis of blood supply
  • Surgical removal
• Unfortunately, digital myxoid pseudocysts often recur, whatever treatment is used.

  Can also become infected - can give antibiotics (flucloxacillin)