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{{Infobox_Disease |
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==Overview==
A '''nodular lesion''' that is > or equal to 1 cm is referred to as a nodule. There are many differential diagnoses for nodules as they can be subcutaneous, intraepidermal, dermal or exophytic. To obtain the correct diagnosis it is importnat to observe the growth rate, color, symptoms and any underlying conditions that may have caused the nodules.


==Causes==
<div style="-webkit-user-select: none;">
===Life Threatening Causes===
*[[Apocrine hidrocystoma]]
*[[Basal cell papilloma]]
*[[Granular cell tumor]]
*[[Melanoma]]
*[[Squamous cell carcinoma of skin]]
*[[Stomach cancer]]
===Common Causes===
*[[Actinic keratosis]]
*[[Angiocentric immunoproliferative lesion]]
*[[Blue nevus]]
*[[Calcinosis cutis]]
*[[Cold panniculitis of haxthausen]]
*[[Cutaneous abscess]]
*[[Cutaneous metastasis]]
*[[Cutaneous nodules]]
*[[Dermatofibroma]]
*[[Dermatofibrosarcoma protuberans]]
*[[Desmoid]]
*[[Enchondromatosis]]
*[[Eosinophilic cellulitis]]
*[[Epidermal inclusion cyst]]
*[[Erythema elevatum diutinum]]
*[[Erythema induratum]]
*[[Erythema nodosum]]
*[[Familial cutaneous collagenoma]]
*[[Focal dermal hypoplasia]]
*[[Follicular infundibulum tumor]]
*[[Garrod pads]]
*[[Granular cell tumor]]
*[[Granuloma annulare]]
*[[Granuloma faciale]]
*[[Juvenile xanthogranuloma]]
*[[Kaposiform hemangioendothelioma]]
*[[Keloid]]
*[[Keratoacanthoma]]
*[[Lipoid dermatoarthritis]]
*[[Lobomycosis]]
*[[Lymphocytoma cutis]]
*[[Malakoplakia]]
*[[Merkel cell carcinoma]]
*[[Microcystic adnexal carcinoma]]
*[[Necrobiosis lipoidica]]
*[[Panniculitis]]
*[[Pigmented naevus]]
*[[Spitz nevus]]
*[[Squamous cell carcinoma of skin]]
*[[Subcutaneous nodules]]
*[[Tendon nodules]]
*[[Tophus]]
*[[Trichofolliculoma]]
*[[Xanthomata]]


==Overview==
===Causes by Organ System===
A '''nodular lesion''' that is > or equal to 1 cm is referred to as a nodule. There are many differential diagnoses for nodules as they can be subcutaneous, intraepidermal, dermal or exophytic. To obtain the correct diagnosis it is importnat to observe the growth rate, color, symptoms and any underlying conditions that may have caused the nodules.
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Amyloidosis]],  [[Angiocentric immunoproliferative lesion]],  [[Angiolymphoid hyperplasia with eosinophilia]],  [[Familial hypertriglyceridaemia]],  [[Ldl receptor deficiency]],  [[Lipoprotein lipase deficiency]],  [[Osler nodes]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Actinic keratosis]],  [[Angiocentric immunoproliferative lesion]],  [[Blue nevus]],  [[Calcinosis cutis]],  [[Cold panniculitis of haxthausen]],  [[Cutaneous abscess]],  [[Cutaneous metastasis]],  [[Cutaneous nodules]],  [[Dermatofibroma]],  [[Dermatofibrosarcoma protuberans]],  [[Desmoid]],  [[Enchondromatosis]],  [[Eosinophilic cellulitis]],  [[Epidermal inclusion cyst]],  [[Erythema elevatum diutinum]],  [[Erythema induratum]],  [[Erythema nodosum]],  [[Familial cutaneous collagenoma]],  [[Focal dermal hypoplasia]],  [[Follicular infundibulum tumor]],  [[Garrod pads]],  [[Granular cell tumor]],  [[Granuloma annulare]],  [[Granuloma faciale]],  [[Juvenile xanthogranuloma]],  [[Kaposiform hemangioendothelioma]],  [[Keloid]],  [[Keratoacanthoma]],  [[Lipoid dermatoarthritis]],  [[Lobomycosis]],  [[Lymphocytoma cutis]],  [[Malakoplakia]],  [[Merkel cell carcinoma]],  [[Microcystic adnexal carcinoma]],  [[Necrobiosis lipoidica]],  [[Panniculitis]],  [[Pigmented naevus]],  [[Spitz nevus]],  [[Squamous cell carcinoma of skin]],  [[Subcutaneous nodules]],  [[Tendon nodules]],  [[Tophus]],  [[Trichofolliculoma]],  [[Xanthomata]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Apocrine hidrocystoma]],  [[Eccrine porocarcinoma]],  [[Eccrine poroma]],  [[Eccrine spiradenoma]],  [[Hidradenoma]],  [[Lipoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Benign cystic mucinous tumor]],  [[Colorectal cancer]],  [[Glycogenosis type 1b]],  [[Stomach cancer]],  [[Xanthomata]][[Benign cystic mucinous tumor]],  [[Colorectal cancer]],  [[Glycogenosis type 1b]],  [[Stomach cancer]],  [[Xanthomata]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Blau syndrome]],  [[Calcinosis-raynaud-sclerodactyly-telangiectasia syndrome]],  [[Cholestanol storage disease]],  [[Cole disease]],  [[Farber lipogranulomatosis]],  [[Lipoid proteinosis]],  [[Nakajo-nishimura syndrome]],  [[Osteopoikilosis]],  [[Systemic hyalinosis]],  [[Systemic sclerosis]],  [[Torg-winchester syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Apolipoprotein c-ii deficiency]],  [[Apoprotein e deficiency]],  [[Basal cell papilloma]],  [[Familial hypertriglyceridaemia]],  [[Glycogenosis type 1b]],  [[Ldl receptor deficiency]],  [[Leukemia cutis]],  [[Lipoid proteinosis]],  [[Spindle cell hemangioendothelioma]],  [[Vitamin e deficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Balamuthia mandrillaris]],  [[Botryomycosis]],  [[Cutaneous abscess]],  [[Cysticercosis]],  [[Enchondromatosis]],  [[Lobomycosis]],  [[Mycobacterium abscessus]],  [[Mycobacterium marinum]],  [[Mycobacterium ulcerans]],  [[Myiasis]],  [[Onchocerciasis]],  [[Protothecosis]],  [[Pyogenic granuloma]],  [[Sporotrichosis]],  [[Tinea profunda]],  [[Zygomycosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Osteopoikilosis]],  [[Pretibial myxoedema]],  [[Tendon nodules]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Neurofibromatosis type 1]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Sitosterolemia]],  [[Vitamin e deficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Breast cancer]],  [[Ovarian cancer]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Apocrine hidrocystoma]],  [[Basal cell papilloma]],  [[Breast cancer]],  [[Bronchogenic carcinoma]],  [[Colorectal cancer]],  [[Cutaneous metastasis]],  [[Dermatofibrosarcoma protuberans]],  [[Desmoid]],  [[Eccrine porocarcinoma]],  [[Eccrine poroma]],  [[Eccrine spiradenoma]],  [[Endovascular papillary angioendothelioma]],  [[Follicular infundibulum tumor]],  [[Granular cell tumor]],  [[Granuloma annulare]],  [[Granuloma faciale]],  [[Hereditary leiomyomatosis]],  [[Hidradenoma]],  [[Keratoacanthoma]],  [[Leukemia cutis]],  [[Lipoma]],  [[Lymphocytoma cutis]],  [[Melanoma]],  [[Merkel cell carcinoma]],  [[Microcystic adnexal carcinoma]],  [[Ovarian cancer]],  [[Pilomatrixoma]],  [[Pyogenic granuloma]],  [[Renal adenocarcinoma]],  [[Sister mary joseph nodule]],  [[Spindle cell hemangioendothelioma]],  [[Spitz nevus]],  [[Squamous cell carcinoma of skin]],  [[Stomach cancer]],  [[Subcutaneous nodules]],  [[Trichofolliculoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Bronchogenic carcinoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Hereditary leiomyomatosis]],  [[Polyarteritis nodosa]],  [[Renal adenocarcinoma]],  [[Renal failure]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Amyloidosis]],  [[Angiolymphoid hyperplasia with eosinophilia]],  [[Calcinosis-raynaud-sclerodactyly-telangiectasia syndrome]],  [[Dermatofibroma]],  [[Farber lipogranulomatosis]],  [[Garrod pads]],  [[Graves' disease]],  [[Heberden nodes]], [[Infantile digital fibromatosis]], [[Juvenile xanthogranuloma]],  [[Kaposiform hemangioendothelioma]],  [[Lipoid dermatoarthritis]],  [[Malakoplakia]],  [[Neurofibromatosis type 1]],  [[Osler nodes]],  [[Otulin related autoinflammatory syndrome]],  [[Panniculitis]],  [[Pigmented naevus]],  [[Polyarteritis nodosa]],  [[Polymyositis]],  [[Pretibial myxoedema]],  [[Rheumatic fever]],  [[Rheumatoid disease]],  [[Sister mary joseph nodule]], [[Tophus]], [[Weber-christian disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
===Causes in Alphabetical Order===
{{columns-list|3|
*[[Actinic keratosis]]
*[[Amyloidosis]]
*[[Angiocentric immunoproliferative lesion]]
*[[Angiolymphoid hyperplasia with eosinophilia]]
*[[Apocrine hidrocystoma]]
*[[Apolipoprotein c-ii deficiency]]
*[[Apoprotein e deficiency]]
*[[Balamuthia mandrillaris]]
*[[Basal cell papilloma]]
*[[Benign cystic mucinous tumor]]
*[[Blau syndrome]]
*[[Blue nevus]]
*[[Botryomycosis]]
*[[Breast cancer]]
*[[Bronchogenic carcinoma]]
*[[Calcinosis cutis]]
*[[Calcinosis-raynaud-sclerodactyly-telangiectasia syndrome]]
*[[Cholestanol storage disease]]
*[[Cold panniculitis of haxthausen]]
*[[Cole disease]]
*[[Colorectal cancer]]
*[[Cutaneous abscess]]
*[[Cutaneous metastasis]]
*[[Cutaneous nodules]]
*[[Cysticercosis]]
*[[Dermatofibroma]]
*[[Dermatofibrosarcoma protuberans]]
*[[Desmoid]]
*[[Eccrine porocarcinoma]]
*[[Eccrine poroma]]
*[[Eccrine spiradenoma]]
*[[Enchondromatosis]]
*[[Endovascular papillary angioendothelioma]]
*[[Eosinophilic cellulitis]]
*[[Epidermal inclusion cyst]]
*[[Erythema elevatum diutinum]]
*[[Erythema induratum]]
*[[Erythema nodosum]]
*[[Familial cutaneous collagenoma]]
*[[Familial hypertriglyceridaemia]]
*[[Farber lipogranulomatosis]]
*[[Focal dermal hypoplasia]]
*[[Follicular infundibulum tumor]]
*[[Garrod pads]]
*[[Glycogenosis type 1b]]
*[[Granular cell tumor]]
*[[Granuloma annulare]]
*[[Granuloma faciale]]
*[[Graves' disease]]
*[[Heberden nodes]]
*[[Hereditary leiomyomatosis]]
*[[Hidradenoma]]
*[[Infantile digital fibromatosis]]
*[[Juvenile xanthogranuloma]]
*[[Kaposiform hemangioendothelioma]]
*[[Keloid]]
*[[Keratoacanthoma]]
*[[Ldl receptor deficiency]]
*[[Leukemia cutis]]
*[[Lipoid dermatoarthritis]]
*[[Lipoid proteinosis]]
*[[Lipoma]]
*[[Lipoprotein lipase deficiency]]
*[[Lobomycosis]]
*[[Lymphocytoma cutis]]
*[[Malakoplakia]]
*[[Melanoma]]
*[[Merkel cell carcinoma]]
*[[Microcystic adnexal carcinoma]]
*[[Mycobacterium abscessus]]
*[[Mycobacterium marinum]]
*[[Mycobacterium ulcerans]]
*[[Myiasis]]
*[[Nakajo-nishimura syndrome]]
*[[Necrobiosis lipoidica]]
*[[Neurofibromatosis type 1]]
*[[Onchocerciasis]]
*[[Osler nodes]]
*[[Osteopoikilosis]]
*[[Otulin related autoinflammatory syndrome]]
*[[Ovarian cancer]]
*[[Panniculitis]]
*[[Pigmented naevus]]
*[[Pilomatrixoma]]
*[[Polyarteritis nodosa]]
*[[Polymyositis]]
*[[Pretibial myxoedema]]
*[[Protothecosis]]
*[[Pyogenic granuloma]]
*[[Renal adenocarcinoma]]
*[[Renal failure]]
*[[Rheumatic fever]]
*[[Rheumatoid disease]]
*[[Sister mary joseph nodule]]
*[[Sitosterolemia]]
*[[Spindle cell hemangioendothelioma]]
*[[Spitz nevus]]
*[[Sporotrichosis]]
*[[Squamous cell carcinoma of skin]]
*[[Stomach cancer]]
*[[Subcutaneous nodules]]
*[[Systemic hyalinosis]]
*[[Systemic sclerosis]]
*[[Tendon nodules]]
*[[Tinea profunda]]
*[[Tophus]]
*[[Torg-winchester syndrome]]
*[[Trichofolliculoma]]
*[[Vitamin e deficiency]]
*[[Weber-christian disease]]
*[[Xanthomata]]
*[[Zygomycosis]]
}}
</div>


== Differential Diagnosis ==  
== Differential Diagnosis ==  

Revision as of 17:27, 22 February 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

A nodular lesion that is > or equal to 1 cm is referred to as a nodule. There are many differential diagnoses for nodules as they can be subcutaneous, intraepidermal, dermal or exophytic. To obtain the correct diagnosis it is importnat to observe the growth rate, color, symptoms and any underlying conditions that may have caused the nodules.

Causes

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular Amyloidosis, Angiocentric immunoproliferative lesion, Angiolymphoid hyperplasia with eosinophilia, Familial hypertriglyceridaemia, Ldl receptor deficiency, Lipoprotein lipase deficiency, Osler nodes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic Actinic keratosis, Angiocentric immunoproliferative lesion, Blue nevus, Calcinosis cutis, Cold panniculitis of haxthausen, Cutaneous abscess, Cutaneous metastasis, Cutaneous nodules, Dermatofibroma, Dermatofibrosarcoma protuberans, Desmoid, Enchondromatosis, Eosinophilic cellulitis, Epidermal inclusion cyst, Erythema elevatum diutinum, Erythema induratum, Erythema nodosum, Familial cutaneous collagenoma, Focal dermal hypoplasia, Follicular infundibulum tumor, Garrod pads, Granular cell tumor, Granuloma annulare, Granuloma faciale, Juvenile xanthogranuloma, Kaposiform hemangioendothelioma, Keloid, Keratoacanthoma, Lipoid dermatoarthritis, Lobomycosis, Lymphocytoma cutis, Malakoplakia, Merkel cell carcinoma, Microcystic adnexal carcinoma, Necrobiosis lipoidica, Panniculitis, Pigmented naevus, Spitz nevus, Squamous cell carcinoma of skin, Subcutaneous nodules, Tendon nodules, Tophus, Trichofolliculoma, Xanthomata
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine Apocrine hidrocystoma, Eccrine porocarcinoma, Eccrine poroma, Eccrine spiradenoma, Hidradenoma, Lipoma
Environmental No underlying causes
Gastroenterologic Benign cystic mucinous tumor, Colorectal cancer, Glycogenosis type 1b, Stomach cancer, XanthomataBenign cystic mucinous tumor, Colorectal cancer, Glycogenosis type 1b, Stomach cancer, Xanthomata
Genetic Blau syndrome, Calcinosis-raynaud-sclerodactyly-telangiectasia syndrome, Cholestanol storage disease, Cole disease, Farber lipogranulomatosis, Lipoid proteinosis, Nakajo-nishimura syndrome, Osteopoikilosis, Systemic hyalinosis, Systemic sclerosis, Torg-winchester syndrome
Hematologic Apolipoprotein c-ii deficiency, Apoprotein e deficiency, Basal cell papilloma, Familial hypertriglyceridaemia, Glycogenosis type 1b, Ldl receptor deficiency, Leukemia cutis, Lipoid proteinosis, Spindle cell hemangioendothelioma, Vitamin e deficiency
Iatrogenic No underlying causes
Infectious Disease Balamuthia mandrillaris, Botryomycosis, Cutaneous abscess, Cysticercosis, Enchondromatosis, Lobomycosis, Mycobacterium abscessus, Mycobacterium marinum, Mycobacterium ulcerans, Myiasis, Onchocerciasis, Protothecosis, Pyogenic granuloma, Sporotrichosis, Tinea profunda, Zygomycosis
Musculoskeletal/Orthopedic Osteopoikilosis, Pretibial myxoedema, Tendon nodules
Neurologic Neurofibromatosis type 1
Nutritional/Metabolic Sitosterolemia, Vitamin e deficiency
Obstetric/Gynecologic Breast cancer, Ovarian cancer
Oncologic Apocrine hidrocystoma, Basal cell papilloma, Breast cancer, Bronchogenic carcinoma, Colorectal cancer, Cutaneous metastasis, Dermatofibrosarcoma protuberans, Desmoid, Eccrine porocarcinoma, Eccrine poroma, Eccrine spiradenoma, Endovascular papillary angioendothelioma, Follicular infundibulum tumor, Granular cell tumor, Granuloma annulare, Granuloma faciale, Hereditary leiomyomatosis, Hidradenoma, Keratoacanthoma, Leukemia cutis, Lipoma, Lymphocytoma cutis, Melanoma, Merkel cell carcinoma, Microcystic adnexal carcinoma, Ovarian cancer, Pilomatrixoma, Pyogenic granuloma, Renal adenocarcinoma, Sister mary joseph nodule, Spindle cell hemangioendothelioma, Spitz nevus, Squamous cell carcinoma of skin, Stomach cancer, Subcutaneous nodules, Trichofolliculoma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Bronchogenic carcinoma
Renal/Electrolyte Hereditary leiomyomatosis, Polyarteritis nodosa, Renal adenocarcinoma, Renal failure
Rheumatology/Immunology/Allergy Amyloidosis, Angiolymphoid hyperplasia with eosinophilia, Calcinosis-raynaud-sclerodactyly-telangiectasia syndrome, Dermatofibroma, Farber lipogranulomatosis, Garrod pads, Graves' disease, Heberden nodes, Infantile digital fibromatosis, Juvenile xanthogranuloma, Kaposiform hemangioendothelioma, Lipoid dermatoarthritis, Malakoplakia, Neurofibromatosis type 1, Osler nodes, Otulin related autoinflammatory syndrome, Panniculitis, Pigmented naevus, Polyarteritis nodosa, Polymyositis, Pretibial myxoedema, Rheumatic fever, Rheumatoid disease, Sister mary joseph nodule, Tophus, Weber-christian disease
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

The unnamed parameter 2= is no longer supported. Please see the documentation for {{columns-list}}.
3

Differential Diagnosis

In alphabetical order. [1] [2]

Diagnosis

History and Symptoms

  • Note the morphology of the nodule
  • size changes
  • tenderness
  • History

Laboratory Findings

  • Appropriate cultures should taken of suppurative lesions

Other Diagnostic Studies

  • Biopsy to determine characteristics of nodule
  • Shave
  • Punch
  • Excisional

Treatment

  • Treatment includes excision whether for cosmetic or symptomatic reasons
  • Epidermoid cysts:
  • Lesions must calm down before excision
  • Intralesional steroids
  • It must be completely removed to avoid a recurrent lesion

References

  1. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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