Unusual Growths After Finger Injury: When to Seek Help

During the healing process of a cut on the index finger, an unknown protruding mass of tissue has developed?

Five years ago, I sustained a cut on my index finger from a metal piece.
The wound was slanted across the finger, resulting in the flesh not being completely severed but remaining attached at the wound site.
During the healing process, it felt like the lower half of the finger healed on its own, while the severed flesh also healed, ultimately forming a small raised mass of tissue on the finger.
Over the past five years, this mass has continued to develop a thickened layer of keratin on its surface, requiring me to trim it with nail clippers.
Additionally, if I pull on the mass, it can tear away from the finger, causing bleeding.
It feels like the skin connecting the mass to the finger is thin, but the center of the mass is still connected to the finger.
The mass is sensitive to pain, indicating it is likely part of the finger's tissue.
It has been gradually increasing in size over the years, and I am unsure what to do.
Should I consult a plastic surgeon for evaluation or consider excision, or should I see a dermatologist? If excision is necessary, how long will the healing process take? Can local anesthesia be administered during the procedure to alleviate pain?

Mr. Hsu, 20~29 year old female. Ask Date: 2023/05/17

Dr. Zhou Hongzhang reply Plastic Surgery

1.
You should consult with a plastic surgeon.

2.
A small protruding lump may be a scar deformity or a granuloma, among other possibilities.

3.
It has persisted for several years, and the symptoms are still present; most cases require surgical treatment.

Reply Date: 2023/05/17

More Info

In your case, it sounds like you have developed a growth, often referred to as a "keloid" or "hypertrophic scar," following your finger injury. This type of growth can occur when the skin heals after a significant injury, leading to an overproduction of collagen, which results in a raised area of skin. Given that this growth has been present for five years and continues to increase in size, it is advisable to seek medical attention.

When to Seek Help
You should consider consulting a healthcare professional, specifically a dermatologist or a plastic surgeon, for a thorough evaluation of the growth. Here are some signs that indicate you should seek help:
1. Persistent Growth: If the growth continues to enlarge over time, it may require medical intervention.

2. Pain or Discomfort: Since you mentioned that the growth can be painful, this is another reason to seek medical advice.

3. Bleeding: If the growth bleeds when pulled or manipulated, it could indicate that it is not healing properly or that it is too thinly connected to the surrounding tissue.

4. Functional Impairment: If the growth interferes with the normal function of your finger, such as gripping or using your hand, it is essential to get it checked.

Treatment Options
1. Observation: If the growth is not causing any pain or functional issues, a doctor may recommend simply monitoring it over time.

2. Surgical Removal: If the growth is bothersome or painful, surgical excision may be the best option. A plastic surgeon would be well-equipped to remove the growth while minimizing scarring. During the procedure, local anesthesia can be administered to reduce pain, and the recovery time will depend on the extent of the surgery.

3. Steroid Injections: In some cases, steroid injections can help reduce the size of keloids or hypertrophic scars without the need for surgery.

4. Laser Therapy: This can be used to flatten the growth and improve its appearance.

Recovery and Healing
If surgical removal is performed, the healing time can vary but generally takes a few weeks. The doctor will provide you with post-operative care instructions, which may include keeping the area clean, applying ointments, and possibly wearing a bandage. Follow-up appointments may be necessary to monitor the healing process.

Conclusion
In summary, given the symptoms you've described, it is advisable to consult with a dermatologist or a plastic surgeon. They can provide a proper diagnosis and discuss the best treatment options for your situation. Surgical removal is a viable option if the growth is causing pain or functional issues, and local anesthesia will help manage any discomfort during the procedure. Remember, timely intervention can prevent further complications and improve your quality of life.

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