Nodule: what is it and when should you worry?
What is a nodule?
A nodule, kezako? A nodule is " a rounded, palpable formation, either on the surface or under the skin "explains Dr. Isabelle Gallay, dermatologist.
Clearly, it is a "ball" present under or on the skin, that can be felt to the touch, and can be visible on the surface with the naked eye. The nodule can (or not) "roll" under the skin, be painful (or not), be red (or not).
Is it serious doctor ? " A nodule can have very different origins: from benign nodule to tumor nodule (carcinoma, melanoma)says Dr. Gallay. When in doubt, if you spot a "ball" somewhere, it is important to make an appointment with a dermatologist to find out exactly what it is and what therapeutic / surgical strategy you need to put in place. "
Nodules linked to dysfunction of the sebaceous gland
What are they like? The nodules related to dysfunction of the sebaceous gland are not very big, they are painful to the touch, red as inflammatory, they are palpable and visible on the surface of the skin. " Most often, they are on the face and they are associated with a acne serious or at a rosacea "says the specialist.
- In case of perioral dermatitis (DPO), the nodules are around the mouth or nose: the pathology is characterized by a cutaneous facial eruption, halfway between acne and rosacea.
- In case of hidradenitis (or Verneuil's disease), there are several nodules (often with a little pus) especially in the fold zones: armpits, pubic, groin ...
- In the case of an epidermal cyst, there is only one nodule that can grow to the size of a walnut. " This mainly concerns smoking and the nodule appears mainly in areas where there are sebaceous glands: face, back, chest ... Dr. Gallay adds. It is commonly called "a magnifying glass" when it develops at the level of the scalp. Some families are subject to it. "
How is it treated? " It is necessary to consult a doctor dermatologist, who will treat the infection (or superinfection) with antibioticssays Dr. Gallay. If there is an epidermal cyst, the antibiotic treatment will be followed by surgery, under local anesthesia. "
What is it about ? " These nodules testify to an inflammation (local or generalized) in the organism: it is the index that the organism reacts to an external aggression says Dr. Gallay.
- Adenopathies correspond to inflammatory ganglia: the nodule is in the form of a mobile ball (it "rolls" under the skin), slightly soft, not necessarily painful to the touch. " They may be an indicator of an infection in this area (whitlow, genital herpes...), but sometimes of a cancerous tumor: It is necessary to consult "develops the specialist.
- Some vasculitis (inflammation of the vessel wall) may be accompanied by nodules. " Erythema nodosum is a fairly common panniculitis (inflammation of subcutaneous adipose tissue) that may be related to an infection (streptococcal or intestinal), says Dr. Gallay. Several touch sensitive nodules are observed, particularly in the lower limbs. "
- In case of foreign body granuloma, local inflammation is related to the penetration of a foreign body (insect sting, sea urchin spine, glass debris ...) in the skin: the nodule is small, rather hard and sensitive to the touch.
How is it treated? " An appointment with the dermatologist is needed to determine the origin of the nodule, says the specialist. In case of granuloma with foreign body, a surgical intervention (under local anesthesia) is necessary. "In case of erythema nodosum, prolonged rest is recommended at the same time as the antibiotic treatment of the responsible infection.In other cases, a thorough assessment is necessary.
Nodules due to degeneration and nodules linked to a malformation
- The painful nodules of the ear constitute nodules by degeneration of the cartilage which reach especially the sportsmen (sports of combat and contact) and the elderly: there can be one or more balls painful to the touch, at the level of the ear .
- Rheumatoid arthritis can also cause the appearance of nodules by degeneration: these are visible on the surface of the skin, and present in the joints.
- Dermoid cysts correspond to malformations at the level of a junction zone (ear, sacrum ...). The ball is rather hard, red and painful to the touch. Present from birth, it is later subject to inflammation.
- " Certain genetic pathologies can also cause the appearance of nodulessays Dr. Gallay. This is particularly the case of neurofibromatosis (or Von Recklinghausen disease) which is characterized by several soft nodules, under the skin or superficial, and coffee-to-milk stains. "
How is it treated? " Again, one must consult a dermatologist doctor: the painful nodules of the ear, in particular, require surgery. "
Infectious and parasitic nodules
- Molluscum contagiosum is mainly about children: it is small nodules similar to chickenpox, and can grow very quickly. The disease (caused by a virus of the family Poxviridae) is very contagious and is transmitted by contact. In adults (it is more rare), these nodules appear rather in the genital area.
- " Some more rare infectious diseases (such as Meadow) can also cause the appearance of nodules ", adds Dr. Gallay.
- " There are also parasitic nodules, linked to the presence of a parasite under the skin. "
How is it treated? An appointment with a dermatologist or a general practitioner is essential. In children, infection with molluscum contagiosum can disappear spontaneously within a few weeks, or evolve by relapses.
The tumor nodules
- The lipoma is a benign tumor nodule in 95% of cases: it corresponds to the proliferation of fat cells and often develops in the intercostal zones and at the level of the shoulder blades. The ball is, in most cases, soft to the touch, can become quite big and deforms the surface of the skin. " Lipomatosis is a family disease where lipomas proliferate all over the body says Dr. Gallay.
- Very common, brown / red in color, histocytofibroma is a benign skin tumor that forms a "disc" when it is pinched between two fingers.
- There are forms of cutaneous cancerous fibroids such as dermatofibrosarcoma: it evolves into a "cluster" of nodules adhering to the underlying muscle.
- Some carcinomas may take the form of a tumor nodule, similar to a pimple that does not heal, which grows to form a "ball" on the skin. The nodule is usually red, irregular, sometimes crusty, not painful to the touch.
- Some carcinomas may take the form of a cancerous nodule tumor: nodular melanoma is a mole that evolves as a small "ball" on the skin. It is not always brown (it can be clear, and it is called "achromic melanoma") and can bleed on contact.
What support ? " It is necessary to make an appointment with a dermatologist who will perform a biopsy at the slightest doubt "says the specialist.
Nodule of the breast, nodule of the thyroid: what is it?
In menstrual or premenstrual period, one can note the appearance of inflammatory nodules in "rosary" at the level of the breast: these are painful but benign. " But an isolated, painless nodule is still suspect says Dr. Gallay, in which case it is necessary to talk to his doctor, who will prescribe the necessary balance sheet.
A thyroid nodule can be inflammatory (it's called thyroiditis) or cancerous. "DComplementary examinations are necessary, hence the importance of making an appointment with the general practitioner: an ultrasound of the thyroid and a determination of the thyroid hormones will determine the origin of the nodule "develops Dr. Gallay.
Thanks to Dr. Isabelle Gallay, dermatologist in Dijon (21) and Vice President of SNDV (National Syndicate of Dermatology Venerology).
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