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Palliative Care7 papers

Retro-auricular cysts (hidradenitis)

Last edited: 4/15/2026

Overview

Retro-auricular cysts, often associated with hidradenitis suppurativa, are chronic inflammatory skin conditions characterized by painful nodules, abscesses, and scarring in apocrine gland-bearing areas, including the retroauricular region 1.

Diagnosis

  • Clinical presentation of painful, recurrent nodules and abscesses in apocrine gland areas 1.
  • Imaging (e.g., ultrasound, MRI) may help differentiate from other deep-seated masses 1.
  • Histopathological examination confirms diagnosis by identifying characteristic inflammatory changes 1.

    • Management

  • First-line treatments:
    • - Topical antibiotics (e.g., clindamycin) 1. - Oral antibiotics (e.g., doxycycline) for moderate disease 1.
  • Adjunctive treatments:
    • - Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation 1. - Biologics (e.g., TNF inhibitors) for severe, refractory cases 1. - Multimodal therapy including psychological support for pain management 1.

    Special Populations

  • Pregnancy:
    • - Use of morphine, paracetamol, amitriptyline cautiously due to fetal risks 1. - Ketamine may be considered under strict supervision 1. - Multimodal pain management essential due to limited pharmacological options 1.

    Key Recommendations

  • Utilize multimodal therapy including pharmacological and psychological interventions for pain management in pregnant patients 1 (Evidence: Expert opinion).
  • Consider imaging studies (ultrasound, MRI) to differentiate retro-auricular cysts from other deep-seated lesions 1 (Evidence: Moderate).
  • Initiate with topical and oral antibiotics for managing mild to moderate hidradenitis suppurativa; escalate to biologic agents for severe cases 1 (Evidence: Moderate).

    • References

    1 Roberts LJ, Goucke CR. Retro-orbital tumour--an uncommon cause of headache in pregnancy. Anaesthesia and intensive care 2001. link

    Original source

    1. [1]
      Retro-orbital tumour--an uncommon cause of headache in pregnancy. — Roberts LJ, Goucke CR Anaesthesia and intensive care (2001)
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