Post-Cellulitis Hard Lump: When to See a Dermatologist or Surgeon?

Induration following cellulitis?

Hello, Doctor.
My father had cellulitis above the right scapula near the shoulder three years ago.
After taking antibiotics, the wound has healed.
However, there is still a hard lump over three centimeters in size that has not softened or disappeared (it can be felt and is visible when wearing clothes).
Should we see a dermatologist or a surgeon for follow-up in this situation? Are there any necessary examinations that we should ask the doctor to arrange? (Previously, we only had an ultrasound.) Thank you, Doctor.
Wishing you peace and well-being.

Liu Xiaojie, 60~69 year old female. Ask Date: 2017/10/15

Dr. Wu Yuxin reply Dermatology

First, consult a surgeon to confirm; it may be scar tissue.

Reply Date: 2017/10/15

More Info

When dealing with a post-cellulitis hard lump, it is essential to understand the underlying causes and the appropriate steps to take for evaluation and management. In your father's case, the hard lump that has persisted for three years after the initial cellulitis may be a result of fibrosis or scar tissue formation, which can occur after an inflammatory process like cellulitis.
Fibrosis is the body's natural response to injury, where the tissue heals by forming scar tissue. This can lead to a hard lump that may not soften or disappear over time. While these lumps are often benign, they can sometimes indicate underlying issues that may require further evaluation.

Given that your father has a hard lump measuring over three centimeters, it is advisable to consult with a dermatologist or a surgeon for a thorough evaluation. A dermatologist specializes in skin conditions and can assess the lump's characteristics, while a surgeon may provide insight into whether surgical intervention is necessary.
During the consultation, the physician may perform a physical examination and consider additional imaging studies beyond the ultrasound that has already been conducted. Depending on the findings, they might recommend a CT scan or MRI to better visualize the lump and surrounding tissues. These imaging studies can help determine the nature of the lump—whether it is simply fibrous tissue, a sebaceous cyst, or something else entirely.

In some cases, a biopsy may be warranted to rule out any malignant processes, especially if there are changes in the lump's size, shape, or texture. A biopsy involves taking a small sample of the lump for histological examination, which can provide definitive information about its nature.

If the lump is confirmed to be benign and not causing any symptoms, the physician may recommend a watchful waiting approach, monitoring the lump for any changes over time. However, if it is causing discomfort, pain, or cosmetic concerns, surgical removal may be considered.

In summary, it is essential for your father to see either a dermatologist or a surgeon for a comprehensive evaluation of the hard lump. The physician will guide you through the necessary steps, including any additional imaging or biopsy, to ensure that the lump is appropriately managed. Early intervention can help prevent potential complications and provide peace of mind regarding your father's health.

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