Survey of Antibiotic Prescription Use for Inflamed Epidermal Inclusion Cysts

Background: Symptomatic epidermal inclusion cysts (EICs) are variously called “inflamed” or “infected,” and the mechanism of inflammation or suppuration is controversial. Whether physicians routinely prescribe antibiotics for inflamed EICs is of concern owing to cost and bacterial resistance. Objectives: To determine whether there is any difference in the diagnosis and treatment of EICs between primary care physicians and dermatologists and to estimate the rate and cost of antibiotic prescriptions for EICs. Methods: One hundred twenty-five primary care physicians and 52 dermatologists were surveyed using a standard case study and a photograph. Results: Sixty-seven percent of the primary care physicians used the term “infected,” whereas 69% of the dermatologists used the term “inflamed” or “ruptured.” Eighty-four percent of the general practitioners and 94% of the dermatologists chose antibiotics for treatment. Conclusion: This study shows that despite the differences between general practitioners and dermatologists in diagnosis, the majority of physicians use antibiotics for the treatment of inflamed EICs.