General Lumps

Question 0

Ddx for subcutaneous lumps

Answer 0

Lipoma
Ganglion
Neuroma
Lymph node

Question 1

Ddx for Intradermal lumps (cannot move skin over it)

Answer 1

Sebaceous cyst
Abscess
Dermoid cyst
Granuloma

Question 2

Tips for examination of lumps

Answer 2

Examine the regional lymph nodes as well as lump

Subcutaneous or Intradermal?

Question 3

Lipoma

Answer 3

Benign fatty lumps
Smooth, imprecise margins, hint of fluctuance, not fixed to skin
Symptoms are only caused by pressure
Not on scalp or palms

Question 4

Sebaceous cyst

Answer 4

Firm, round, mobile subcutaneous nodules
Characteristic central punctum
Infection quite common
Common on scalp, face, neck, trunk

Question 5

Cutaneous abscess

Answer 5

Staphyloccocci most common organism
Hemolytic streptococci only common in hand infections
Proteus common non-staph axillary abscess
Txt: incise and drain
* think hidradenitis suppurativa if recurrent inguinal or axillary abscesses *

Question 6

Rheumatoid nodules

Answer 6

Collagenous Granulomas which appear in established RA on extensor aspects of joints, esp elbows

Question 7

Ganglia

Answer 7

Degenerative cysts from an adjacent joint or synovial sheath commonly seen on the dorsum of the wrist, hand or foot
May transilluminate
50% disappear spontaneously
Aspiration may be effective

Question 8

Fibroma

Answer 8

May occur anywhere
Commonly under the skin
Whitish, benign tumours contain collagen, fibroblasts, fibrocytes

Question 9

Dermoid cysts

Answer 9

Contain dermal structures

Found in midline or lateral to eye

Question 10

Keloid scar

Answer 10

Irregular hypertrophy of vascularised collagen forming raised edges at sites of previous scars that extend outside the scar
Common in dark skin
Txt difficult
Intra lesions steroid injections