September 2021 - Case of the Month
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 64 year-old woman presented with a swelling affecting the distal aspect of the fourth finger of her right hand. From time-to-time it discharged a clear thick fluid. She was also complaining of a nail deformity affecting the same finger. There were no other skin or nail complaints.
The woman also had osteoarthritis for which she took paracetamol.
Examination revealed a firm, translucent, swelling just back from the nail fold. There was a longitudinal ridge of the nail.
What is the diagnosis?
The diagnosis is a myxoid cyst
A myxoid cyst is a form of ganglion, and usually arises from the synovial lining of the distal interphalangeal joint of a finger. It is often associated with osteoarthritis.
The cyst is seen around the proximal nail fold. It has a smooth shiny surface, and a clear jelly-like fluid may be expressed. As a result of pressure the cyst often causes a lateral groove in the nail, a few mm across, which extends the length of the nail.
Lesions are generally managed conservatively and left alone. If the cyst is uncomfortable it can be punctured by a needle, and the jelly-like fluid expressed, however, it may only give temporary relief if the cyst fills again. For persistently troublesome cases, the cyst can by surgically removed by a hand surgeon, although even then there is still a risk of recurrence.
For more information please refer to the related chapters on Ganglion's and/or Nail Disorders
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 52 year old man presented with a one year history of skin lesions predominantly on his hands, ears and scalp. He was also complaining of painful swollen fingers associated with morning stiffness. There was no family history of skin or joint problem...
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Welcome back to the new look PCDS website, and our first case. This lady was referred as a 2-week wait with a changing lesion on the right temple.
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