Nodular lesions

Nodular lesions

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

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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.

Differential Diagnosis

In alphabetical order.

• Dermatofibroma
• Dermal/subcutaneous neoplasms
• Epidermoid
• Epidermal inclusion cyst
• Ganglion cyst
• Hypertrophic scars
• Kaposi's sarcoma
• Lipoma
• Nodular melanomas
• Pilar cyst
• Pyogenic granuloma
• Xanthoma

Diagnosis

History and Symptoms

• Note the morphology of the nodule

• size changes
• tenderness

• History

• malignancies/ rheumatoid arthritis
• immunosupression
• family history of melanoma

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

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