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Updated 28 May 2014

Skin lump

Skin lumps are any unusual bumps or swellings on the skin.

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Definition


Skin lumps are any unusual bumps or swellings on the skin.

Causes


  • Lipomas
    A lipoma is a benign, slow-growing, fatty tumour which is lobulated.  It is a soft, mobile” lump” beneath the overlying skin and is most commonly on the neck and trunk.  The size is usually less than 6cm and it is rarely painful.  The peak occurrence is in the fifth or sixth decade of life.
    Surgical excision is necessary to remove the lipoma and to ensure that it does not have any cosmetic effect.

  • Enlarged lymph glands (lymphadenitis)
    Predisposing factors of lymphadenitis are trauma to the skin, obstruction of normal drainage, chemical irritation, haematoma (formation of a blood clot) and foreign bodies.  The process usually begins as a cellulitis (infection of the skin), which leads to necrosis (dead skin formation) and loculation of pus and the forming of an abscess, as well as lymphatic spread, namely lymphadenitis.
    Upon inspection, the skin will appear red, tender, warm and swollen.  The patient can also be systemically ill and can present with symptoms of mild fever and malaise.
    You have to consult your doctor immediately to have the correct diagnosis made and to commence with the correct treatment.

  • Cyst
    A cyst is an abnormal closed membranous cavity containing fluid or semi-solid material.  It is usually well encapsulated and is rarely painful.  Cysts can become secondarily infected and cause a painful red lump beneath the skin.  Do not squeeze the lump, as it may spread and cause cellulitis (skin infection).
    You should not try to treat this at home.  Consult a doctor to excise the cyst surgically to prevent reoccurrence.

  • Boils
    Boils are firm, red, tender nodules, usually in the neck, back and buttocks area.  They become fluctuant; pus-filled and will rupture eventually.  This will cause drainage of the pus.  The infection is usually due to the staphylococcus bacteria.
    Treatment at home can be done by applying anti-bacterial ointment (Bactroban topical cream) and by taking oral anti-inflammatories.  If the boil is very large and painful, it is necessary to consult your doctor, in order to have it incised and drained.  Sometimes a systemic antibiotic is necessary to treat the boil and the surrounding cellulitis.

  • Corn or callus

  • Warts (verrucae vulgaris)
    Warts are benign epidermal neoplasms caused by the human papillomavirus and are usually transmitted by touching.  The lesions can have various appearances.  Common areas infected include the face, hands, eyelids, soles of the feet, palms and the genital tract.   Common warts appear dome-shaped, flesh-coloured and with dots on the surface.  Plantar warts are tender, round nodules, typically found on the sole of the foot.  Up to two thirds of warts regress spontaneously within two years.
    Treatment at home can be done by purchasing anti-wart creams topical salicylate at your pharmacy.  Non-pharmaceutical treatment is available at your doctor.  These include cryotheraphy and CO2 laser.  Oral medication is not effective.

  • Moles (nevus)
    Moles are benign tumours composed of nevus cells derived from melanocytes located in the epidermis (top layer of the skin) or dermis.  They may be macular or nodular and are typically brown, black or bluish in colour.  They usually appear in childhood and adolescence.
    Treatment will be excision under local anaesthetic for cosmetic reasons.  If a mole has variegated coloration (red, white or blue areas in a brown mole) or it has irregular borders, it should raise suspicion for melanoma and you should consult your doctor immediately for a biopsy and excision of the mole.

  • Abscess (cutaneous abscess)
    An abscess is localised infection, usually caused by the staphylococcus bacteria.  It usually is a nodular mass that is tender to the touch, and the skin overlying the abscess is red in colour.  It is often surrounded by cellulitis (skin infection).  When on the buttocks, it may be deep, with minor surface changes.  If you have a history of a prior non-tender nodule at the same site, it suggests an inclusion (sebaceous) cyst, with secondary infection.
    If the abscess is “pointing”, it needs to be drained if fluctuant and if it is not fluctuant, it should be treated with antibiotics.  You should therefore, consult your doctor to have the area examined.  Oral non-steroidal anti-inflammatories can be taken at home for temporarily pain relief.

  • Cancer
    Skin cancer be abnormal moles, basal cell carcinoma (most common form of skin cancer – originates in the basal layer of the epidermis), squamous cell carcinoma (potentially invasive cancer arising from keratinocytes) and metastatic skin lesions (most commonly present as discrete, firm, non-tender, skin coloured nodules which are stationary).
    If cancer is suspected, contact your doctor immediately.  A biopsy will be done to make a histological diagnosis.  Treatment will be dependent on the histology of the biopsy.

Written by Dr Anrich Burger, MB ChB (Stell)

 
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