title: Management of digital mucous cysts: a systematic review and treatment algorithm.
abstract: 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.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Saint Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Samer
authors.initials: S
authors.lastname: Jabbour
authors.affiliation: Department of Dermatology, Faculty of Medicine, Saint Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Elio
authors.initials: E
authors.lastname: Kechichian
authors.affiliation: Department of Dermatology, Faculty of Medicine, Saint Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Roger
authors.initials: R
authors.lastname: Haber
authors.affiliation: Department of Dermatology, Faculty of Medicine, Saint Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Roland
authors.initials: R
authors.lastname: Tomb
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Saint Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Marwan
authors.initials: M
authors.lastname: Nasr
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000465:Algorithms; D017679:Cryotherapy; D003560:Cysts / Q000601:surgery / Q000628:therapy*; D005385:Fingers; D006801:Humans; D015911:Sclerotherapy; D012871:Skin Diseases / Q000601:surgery / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones