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Q. What is the cause for the development of a pea-sized red tender lump on the skin?

Answered by
Dr. Sandeep Golla
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Oct 30, 2021

Hi doctor,

I have a small pea-sized red tender lump on the back of my shoulder blade. It has been there for about a month. I am taking Paxil. Kindly help me.

#

Hi,

Welcome to icliniq.com.

Please share few clear pictures of the lesion so that I can give a better opinion.

Hi doctor,

Thank you.

I have attached the pictures. Kindly give your opinion.

#

Hi,

Welcome back to icliniq.com.

I got the pictures (attachments removed to protect the patient's identity). I will be able to give a better opinion if the pictures are taken from the top of the lesion.

Hi doctor,

Thank you.

That is the best I could get right now. It is in a tough spot to take a picture. Can you give me your thoughts based on the picture and information that I have sent already?

#

Hi,

Welcome back to icliniq.com.

We can consider two differential diagnoses here with the images and information provided. They are:

1) Epidermoid cyst or sebaceous gland cyst. It grows slowly due to sebum secretion in the cyst. It is a benign growth only.

2) Lipoma - a soft, benign growth in fat cells underneath the skin. It moves easily in a parallel direction.

Suppose possible, please forward a few pics from the top of the lesion to guide you in a better way. I hope this was helpful.

Hi doctor,

Thank you.

I have attached few more pictures. Kindly give your opinion.

#

Hi.

Welcome back to icliniq.com.

I can see a punctum (opening of the cyst) in the attached picture (attachments removed to protect the patient's identity). It is an epidermoid cyst only. You can ignore it or can get it excised under local anesthesia if it is bothering you.

I hope this was helpful.

Hi doctor,

Thank you.

I read on rare occasions, an epidermoid cyst can lead to cancer. What should I look for signs of cancer? Kindly give your opinion.

#

Hi,

Welcome back to icliniq.com.

Check for the following signs:

1) Number - if their number is increasing with more than 20 to 30 lesions, then plan for a biopsy.

2) Colour - normal color is skin color with a black dot on the top. If the color changes drastically with a red hue, then plan for a biopsy.

3) Symptoms - usually, the epidermoid cyst is symptomless. If you notice severe pain, then cross-check with your doctor for a physical examination.

It is only a cosmetic concern. You can take a picture and compare it once in four to six months, or else plan for an excision biopsy whenever you find some time.

I hope this was helpful.


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