Surgical Deroofing and Trichloroacetic Acid Application: A Novel Treatment for Digital Mucous Cysts

Digital mucous cysts (DMCs) are benign cysts located in digital interphalangeal joints or the proximal nail fold. Despite various treatments, standardized guidelines are lacking, and recurrence rates remain high.

This study evaluates the efficacy and safety of a novel treatment combining surgical deroofing with trichloroacetic acid application.

This study was conducted on 27 patients with DMCs treated from 2019 to 2022. Clinical features and therapeutic responses were documented with photographic records at the initial presentation and follow-ups. Histopathological examinations confirmed diagnoses and classified histopathological types.

Among 27 lesions, 20 were within the proximal nail fold, 7 were beneath the proximal nail fold; 26 were ganglionic, and 1 was myxomatous. Four patients required multiple treatments within 6 months due to recurrences. Long-term follow-up showed clinical improvement in all patients: 17 achieved complete remission, and 8 showed partial improvement. The treatment was effective regardless of cyst type, with minimal complications and mild postoperative pain resolving within days.

The combination of surgical deroofing and trichloroacetic acid application minimizes complications and enhances efficacy. It allows for repetitive treatments in case of recurrence, making it a viable option for managing persistent DMCs, with favorable outcomes and minimal complications.