Clinical features

Clinical features:

• usually solitary, round-to-oval, dome-shaped, firm-to-fluctuant papulonodules
• grooving of the nail may precede the clinical manifestation of the cyst itself by up to 6 months
• classic clinical presentation is that of a slow-growing, well-localized mass that is most often solitary in nature
• lesion typically appears as a dome-shaped, oval, or round lesion that occurs predominantly on the dorsal aspect of the distal phalanges
  • cyst may be soft, indurated, or fluctuant in nature
  • cyst is often translucent and smooth and may vary in color from pink to white
  • lesion most often afflicts women, with a 3 to 1 ratio over men.
  • cyst occurs more commonly in middle-aged to elderly patients
  • size may vary from 1-10mm in diameter
  • patient often describes a clear viscous drainage from the affected area if the cyst ruptures
  • mass may expand and contract throughout its course
  • the lesion typically will reform within 2 months after a rupture
  • cysts can be symptomatic, especially when located in areas of pressure
  • symptoms can include burning, itching, or pain on palpation of the lesion
  • patients may relate a history of acute nail changes, which can include ridging or longitudinal depressions in the nail plate
  • on occasion, the cyst may present in a subungual location
• click here for an example image of a mucoid cyst
  

Reference:

• 1) Blume PA et al. Digital mucoid cyst excision by using the bilobed flap technique and arthroplastic resection. The Journal of Foot and Ankle Surgery (2005);44, 44-48.