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Lumps and Bumps

Introduction
Patients will often find small abnormal raised area (lumps and bumps) either in or just underneath their skin. There are many causes of skin lumps and bumps most of which are of no clinical concern. The location and characteristics of a lump in or under the skin will often give a clue as to its cause. Patients finding a new lump in their skin or underneath should contact their GP, and if the lump increases in size this should be done urgently.

Common causes of skin lumps and bumps include the following:

Lipomas
Lipomas are benign growths in the fat layer immediately under the skin. They usually cause no symptoms and operations to remove these lumps can be undertaken, usually under local anaesthetic, to establish the diagnosis. Lipomas may be painful or unsightly, and either of these reasons would be an indication for removal if a patient requested. Very rarely lipomas can increase in size, and in the situation removal is recommended urgently to ensure that they are not malignant tumours (liposarcomas).

Skin Moles
Most coloured moles in or on the skin surface are benign and require no treatment. If however a new pigmented lesion appears in the skin, or an existing mole becomes bigger, bleeds or starts to itch, then urgent consultation with a specialist is recommended.

Sebaceous Cysts
These are firm benign swellings of the sweat glands in the skin. They are often asymptomatic but may cause discomfort or become infected (red and painful).

Patients may think they are unsightly and removal under local anaesthetic is often undertaken. These cysts may recur following removal if the cyst wall is not fully removed.

Lymph Nodes
Patients will feel a hard lump deep under the skin. There are many reasons why lymph nodes become enlarged, most of which are benign and of no concern. Painful lymph nodes often indicate local infection, but in all cases early consultation with a GP or hospital specialist is recommended. The common sites of enlarged lymph nodes is often under the skin in the groin, neck or in the armpit (axilla).

Management
Sometimes it is very apparent that a lump is benign and if it is causing no symptoms then it can be left alone. However, if there is any cause for concern or the lump is causing symptoms, then surgical removal under local anaesthetic is usually performed to confirm the diagnosis by examining the lump under a microscope. If a patient is concerned at any stage then early consultation with their GP and/or a hospital specialist is recommended.

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