Derm Dx: A large mass on the scalp - Clinical Advisor

Derm Dx: A large mass on the scalp

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A 40-year-old African American man presents for evaluation of a mass affecting his posterior scalp, which has enlarged in size during the past 3 to 4 years. The growth is asymptomatic. Examination reveals a soft and somewhat movable nodule that is nontender to palpation. Keloidal papules are noted on his lower scalp. No other masses are found elsewhere.

Lipoma is a tumor composed of adipose tissue that can arise anywhere on the body.1 These fatty masses are localized to the subcutaneous tissue and form most commonly in middle age. Lesions are slow growing and asymptomatic in a majority...

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Lipoma is a tumor composed of adipose tissue that can arise anywhere on the body.1 These fatty masses are localized to the subcutaneous tissue and form most commonly in middle age. Lesions are slow growing and asymptomatic in a majority of patients. Multiple lipomas may be associated with disorders such as multiple hereditary lipomatosis, Gardner syndrome, adiposis dolorosa, and Madelung disease.2

Diagnosis is usually apparent based on clinical appearance. Unsightly tumors or those that are symptomatic may be definitively removed by surgical excision.3 Less invasive therapies include extrusion via punch4 and injection with deoxycholate.5

Rebecca Geiger is a physician assistant at the Dermdox Center for Dermatology in Hazleton, Pa. Dr Schleicher is director of the DermDox Center for Dermatology, as well as an associate professor of medicine at the Commonwealth Medical College and a Clinical Instructor of dermatology at Arcadia University and Kings College.

References

1. Goldsmith L, Katz S, Gilchrest B, et al. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York: McGraw-Hill Education; 2012.

2. Charifa A, Badri T. Lipomas, pathology. Available at: https://www.ncbi.nlm.nih.gov/books/NBK482343/ (Accessed April 20, 2018).

3. Vatanchi M. Cutaneous lipomas. Updated May 10, 2017. Available at: https://emedicine.medscape.com/article/1057855-overview (Accessed April 20, 2018).

4. Christenson L, Patterson J. Davis D. Surgical pearl: Use of the cutaneous punch for the removal of lipomas. J Am Acad Dermatol. 2000;42:675-676.

5. Rotunda AM, Ablon G, Kolodney MS. Lipomas treated with subcutaneous deoxycholate injections. J Am Acad Dermatol. 2005;53:973-978.

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