title: Skin conditions: benign nodular skin lesions.
abstract: Benign subcutaneous lesions are a common reason that patients visit family physicians. Lipomas are the most common of these lesions; they most often occur on the trunk and proximal extremities. Recent data show that as many as half of the fat cells in lipomas are atypical. Ultrasound is used increasingly to confirm lipoma diagnosis, but deep lesions should be evaluated with magnetic resonance imaging study or computed tomography scan to exclude involvement of underlying structures and/or liposarcoma. Small lesions can sometimes be managed with serial injections of midpotency steroids. Larger lesions (larger than 5 cm), those compressing other structures, or those suspicious for malignancy should be excised using standard surgical excision or, when possible, the newer minimal-scar segmental extraction technique. Ganglion cysts are another common lesion, the presence of which often is confirmed with ultrasound if the diagnosis is not clinically apparent. Management includes splinting, aspiration, and/or injection of steroids, with or without hyaluronidase. Epidermal inclusion cysts, also called sebaceous cysts, typically are asymptomatic unless they become infected. Ultrasound can aid in diagnosis. The only definitive management is surgical excision with complete removal of the cyst wall or capsule, using minimal-scar segmental extraction or conventional surgical removal.
authors.affiliation: San Joaquin General Hospital, French Camp, CA 95231, USA. tampsu@hotmail.com
authors.forename: Tam
authors.initials: T
authors.lastname: Nguyen
authors.forename: Ramiro
authors.initials: R
authors.lastname: Zuniga
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003560:Cysts / Q000175:diagnosis* / Q000628:therapy*; D062109:Dermatologic Surgical Procedures / Q000379:methods; D004814:Epidermal Cyst / Q000175:diagnosis / Q000601:surgery; D045888:Ganglion Cysts / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008067:Lipoma / Q000175:diagnosis* / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000000981:diagnostic imaging / Q000473:pathology; D012871:Skin Diseases / Q000175:diagnosis / Q000628:therapy; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D040521:Subcutaneous Tissue / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography
chemical_list: D000305:Adrenal Cortex Hormones