By: Christopher Marsh, PA-C

Lumps and bumps, whether they are new or old, should be evaluated by a dermatologist. Many lumps and bumps are benign or harmless; however some are not. Examples of benign lesions include pilar cysts (a common scalp bump), epidermoid cysts (common on face and trunk), milia, dilated pore of Winer, and lipomas.

So, what are these things?

Pilar cysts: These occur mainly on the scalp, are not usually tender, can become large, and tend not to resolve on their own. They can, though rarely, undergo malignant transformation, which is an acceptable reason to have them removed.

Epidermoid cysts: These are the most common cutaneous cysts. They occur more frequently on the face and trunk, but can occur anywhere. They can arise from an injury to a hair follicle. Though many are painless, often they can be inflamed, infected, and also rupture to expel foul-smelling, cheesy contents. They can change in size, be unsightly, drain their contents, and be cosmetically unpleasing. They should be removed.

Milia: Very small versions of epidermoid cysts. They are nearly always on the face, are small and white, and are generally harmless. They can get bigger, rupture, and grow in number. We can remove them too.

Dilated Pore of Winer: These are actually benign tumors that look like a large nodular black head. Their cause is unknown but thought to be associated with hair follicles. They can become large, infected and also unsightly. They can be removed.

Lipomas: These are benign fat tumors that occur under the skin. They can occur from an injury or for no reason at all. Lipomas can become quite large, can impinge on important structures, and can become inflamed and painful. We commonly remove them.

These are all benign, though there are also many mimickers in dermatology too, that may present or look like one of the above. For example, I was sent a young patient who had a cyst that needed to be removed. It looked benign and typical to the sending provider and to me as well. When I removed it, it did not look like a common epidermoid cyst, and the post-excision biopsy proved it certainly wasn’t.

This example is not meant to scare patients into getting excisions, but lumps and bumps are not identified with 100% certainty until we remove them and test them via biopsy. So, if you have a lump or bump that is bothering you in any way, give our office a call and myself or another provider will take a look. And please, do not squeeze or “pop” these lumps and bumps.

Christopher Marsh is a Physician Assistant and is accepting new patients in Linwood and Cape May Court House.  For an appointment call (609) 926-8899.