Nail & Skin Disorders

What Are Myxoid Cysts?

Myxoid cysts are small, rounded deformities that occur around the fingers and toes. Though often harmless, a visit to the doctor is still suggested to rule out any larger issue.

myxoid (mix-oid) mucous; resembling mucous; cyst (sist) a closed sack with a distinct membrane that develops abnormally. 

The body occasionally develops lumps and bumps that are filled with fluid. These growths are medically defined as “cysts.” Though peculiar, they are often painless. Two types of cysts that nail techs may see in the course of their day are the “ganglion cyst” and the “myxoid” or “mucous” cyst. Many times these can be confused as the same condition, but they are actually quite different.

“Ganglion cysts form when the joint-space lining herniates its way out from the joint space,” says Dr. Jerome Aronberg, a dermatologist in private practice in Clayton, Mo., and assistant clinical professor of dermatology at Washington University in St. Louis. “The ganglion cyst has a direct connection to the nearby joint space, and any treatment of this lesion should be undertaken with care, so as to prevent damage to the connected joint space.” The treatment would be to find the connection and ligate it or destroy it, says Dr. Aronberg. He notes that a ganglion cyst is found most often in people who have arthritic fingers, generally osteoarthritis, with bony spurs in the area of the joint spaces. The cysts most often form between the distal interphalangeal joint (the joint of the finger closest to the nail) and the nail plate. Treatment may require the attention of a hand plastic surgeon.

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A myxoid cyst, also called a digital mucous cyst, is identified by the clear mucous that fills it. It’s a firm, smooth, rounded bump on the skin, often having a bluish tint. Inside, it is filled with clear, sticky, gelatinous fluid. The cysts appear most often on the fingers but can also show up on the toes. “The myxoid cyst generally  occurs in the proximal nail fold (the skin surrounding the cuticle),” says Dr. Aronberg. Cysts form from some sort of minor trauma to the site. The minor trauma can be caused by a repetitious act, including something as simple as typing or even repetitive rubbing of the area. A patient may not even be able to identify the cause.

The cyst may grow in a spot on the finger that is far enough away from the nail fold to prevent the nail from becoming distorted, but many times the cyst will cause the nail to change shape. When the cyst rests on top of the nail matrix, a depression or groove occurs on the nail plate, because of the pressure on the matrix, says Dr. Aronberg. “However, should the cyst happen to occur under the matrix, then the unit is forced upwards and the result is a bump in the nail rather than a depression,” he explains.

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