Skip to content

What are the probable diagnosis of a Swelling or a Lump

  • by
Swelling Differential diagnosis

Diagnosis can be 1. Traumatic, 2. Inflammation, 3. Abscess, 4. Furuncle, 5. Carbuncle, 6. Dermoid cyst, 7. Haemangiomas, 8. Neoplasia. 9. Others.

1. Traumatic causes :

These are primarily caused by the skin. It can also come from the subcutaneous tissues in rare circumstances. Swelling can result from a haematoma after a trauma.

2. Any Inflammation :

There may be two types of inflammatory causes, they are – Erysipelas and Cellulitis.

  1. Erysipelas – This is a type of cuticular lymphangitis that can develop after even a little scratch. Streptococcus pyogenes is the most common causal bacteria.
  2. Cellulitis – This is a suppuration, sloughing, or even gangrene of the affected region caused by a spreading inflammation of the subcutaneous and facial tissue.

Clinical features :

Erysipelas :

  • This starts as a rose-pink rash that spreads to the surrounding skin.
  • The vesicles develop and break sooner or later across the rash.
  • These vesicles produce a serous discharge.

Cellulitis :

  • There isn’t any discernible edge.
  • The symptoms begin with redness, irritation, and stiffness at the injection site.
  • The regional lymph nodes that drain the area swell, giving the appearance of acute lymphadenitis.
  • Lymph vessels can be seen as red streaks.
  • Pitting pressure indicates that the portion is gradually becoming brawny and oedematous.

3. Abscess :

A bacterial infection frequently causes an abscess, which is a painful collection of pus. Abscesses can form in any part of the body.

Clinical features :

Pyogenic abscess, Pyaemic abscess, and Cold abscess are the three types of abscess that can occur.

  1. Pyogenic abscess – Pyogenic refers to the production of pus.
  2. Pyaemic abscess – Pyaemia is a kind of sepsis that causes metastatic abscesses to spread throughout the body. It is mainly caused by pus-forming organisms in the blood, which are produced by the staphylococcus bacterium.
  3. Cold abscess – A cold abscess is a type of abscess that doesn’t have the same level of inflammation as a typical infection. This could be linked to illnesses caused by bacteria like TB or fungi like blastomycosis, which don’t cause acute inflammation.

4. Furuncle :

A “boil” is sometimes known as a “furuncle.” Boils are bacterial infections that affect the hair follicles and the surrounding tissue. Infected hair follicles can appear everywhere on your body, not just on your scalp. The hair follicle becomes inflamed when it becomes infected.

The most common cause of furuncle is Staphylococcus aureus.

Clinical features :

  1. Infected, irritated hair follicles generate a painful, pus-filled lump under the skin.
  2. If it bursts then can show discharge

5. Carbuncle :

This is a larger kind of boil or furuncle, with Staphylococcus aureus as the causing bacterium once again.
These are most common on the back and nape of the neck, where the skin is coarse and the tissue’s vitality is low.

Clinical features :

  • This starts as a painful and stiff swelling that spreads quickly with induration.
  • The skin beneath it becomes reddened, sallow, and oedematous.
  • These openings expand and eventually merge to form an ulcer, beneath which the ashy-grey slough sits.

6. Dermoid Cyst :

A dermoid cyst is a tissue collection beneath the skin. Hair follicles, oil, and sweat glands may be present. It may contain bone, teeth, or nerves in some situations. A dermoid cyst can occur at or shortly after birth. Dermoid cysts can appear anywhere on the head, neck, or face, although they’re most common around the eyes.

Clinical features :

  • The swelling is smooth and spherical in appearance.
  • The margin will give to finger pressure but will not disappear.
  • The swelling will be removed from both the surface and the deeper structures.
  • Because to the presence of pultaceous material inside the cyst, there will be fluctuation but no translucency.

7. Haemangiomas :

A hemangioma, also known as a haemangioma, is a benign vascular tumour that develops from blood vessel cell types. Capillary haemangiomas(due to capillary malformation) and Cavernous haemangiomas(Venous malformation) are the two forms of haemangiomas. Another arterial haemangioma is Plexiform haemangioma. Other differential diagnosis can be Congenital arteriovenous fistula, and Glomangioma.

Clinical features :

  1. Capillary haemangiomas – These patches are bright red or purple in colour and range in size. They’re usually flat and don’t rise much above the skin’s surface. When pressure is applied, the colour may completely vanish or fade, but it returns as soon as the pressure is released. Capillary haemangiomas are classified into six types : Strawberry angioma, Port-wine stain, Salmon patch, Spider naevus, Vin rose patch, Campbell de Morgan spot
  2. Cavernous haemangioma – The capillary haemngioma is smaller than this one. This is made up of dilated areas that collect blood and result in a soft spongy bluish swelling that is compressible and can be emptied by pressure but returns when the pressure is released.
  3. Plexiform haemangioma –CISTOID ANEURYSM is caused by a network of dilated interconnected arteries that look like a sack of pulsating earth worms.
  4. Congenital arteriovenous fistula – This is the result of congenital communication between the arteries and veins, which mainly affects the extremities.
  5. Glomangioma – This is the result of congenital communication between the arteries and veins, which mainly affects the extremities.

8. Neoplastic causes :

Benign causesMalignant causes
1. Papilloma
2. Fibroma
3. Lipoma
4. Neurofibroma
5. Neurilemmoma/Schwannoma
6. Lymphangioma
7. Moles
1. Basal cell carcinoma
2. Squamous cell carcinoma
3. Sarcoma
4. Malignant melanoma
Benign and Malignant causes of a swelling or lump

Benign causes :


This is a basic overgrowth of the skin’s layers. Pedunculated growth with branched villous processes is the most common kind. A central axis of connective tissue, blood arteries, and lymphatics make up this system.
The skin is the most common place, followed by the lip, tongue, vocal cord, colon, rectum, and kidney.


  • Fibromas are made up of fibrous tissue, also known as connective tissue. The majority of fibromas are seen in combination with other mesodermal tissues, such as fat, muscles, nerve sheaths, and so on.

  • Fibroma is characterised by a non-painful, solid, confined swelling that glides freely over the underlying structures.
  • Fibromas can be firm or soft depending on the amount of fibrous tissue they contain, according to their consistency.

Lipoma –

  • fatty tissue lumps that form right beneath the skin When you touch a lipoma, it moves freely and feels rubbery, not rigid. Lipomas are rarely treated because they are rarely painful or cause health issues.
  • Lipomas are divided into three categories: encapsulated, diffuse, and multiple lipomas.

Neurofibroma –

A neurofibroma is a type of nerve tumour that appears as soft lumps on the skin or beneath it. A neurofibroma can form in any major or minor nerve throughout the body. This sort of benign nerve tumour is more likely to occur near the centre of the nerve.

Neurilemmoma/Schwannoma –

Schwannoma is a type of tumour that develops in the nerve system and is extremely rare. Schwannoma is made up of cells known as Schwann cells. Schwann cells protect and support the nervous system’s nerve cells.

Lymphangioma –

  • Lymphangiomas, also known as lymphatic malformations, are fluid-filled cysts that develop in lymphatic vessels and are noncancerous. The lymphatic system is made up of these veins, which contain a material called lymph. Lymph assists in the proper regulation of fluid in human tissue.
  • There are mainly three types of lymphangioma are seen, and they are – Capillary lymphangioma, cavernous lymphangioma, and Cystic hygroma.

Moles –

  • Moles are a sort of skin growth that is very prevalent. Clusters of pigmented cells cause them to appear as small, dark brown spots on the skin. Moles are more common in childhood and adolescence.
  • Various types of moles are seen – Hairy mole, Juvenile mole, Non-hairy mole, Blue naves, Junctional naves, Compound naves, and Hutchinson’s freckle or lentigo.

Malignant causes :

  • Basal cell carcinoma – Basal cell carcinoma is a kind of skin cancer that starts in the basal cells.
  • Squamous cell carcinoma – SCC is a type of skin cancer that grows slowly. It can spread to the tissues, bones, and adjacent lymph nodes, unlike other types of skin cancer, making treatment difficult.
  • Sarcoma – A cancer that starts in the body’s soft tissues, such as cartilage, fat, muscle, blood vessels, fibrous tissue, or other connective or supportive tissue. The location of the disease causes different types of sarcoma.
  • Malignant melanoma – This is a kind of skin cancer that arises from pigment-producing cells called melanocytes. Melanomas are most commonly found on the skin, although they can also develop in the mouth, intestines, or eyes (uveal melanoma).

9. Other causes :

  • Sebaceous cyst – Sebaceous cysts are noncancerous skin cysts that are prevalent. Cysts are bodily anomalies containing liquid or semiliquid substance. The face, neck, and chest are the most common sites for sebaceous cysts.
  • Condyloma – The medical term for genital warts is condyloma. Warts on the genital area are soft, noncancerous growths that can appear on the outside or inside of your vaginal or anus canals, as well as inside the cervix (the lower part of the uterus that connects to the vagina).
  • Keloid/Hypertrophic scar – When the skin is wounded, fibrous tissue known as scar tissue grows over the wound to heal and protect it. Extra scar tissue can grow and form keloids, which are smooth, hard growths. Keloids can grow to be several times the size of the initial wound.
  • Callosity and corn – Friction and pressure generate thick, hardened layers of skin.
  • Keratocanthoma(Molluscum sebaceum) – Keratoacanthoma (KA) is a low-grade tumour that starts in the pilosebaceous glands and looks a lot like squamous cell carcinoma (SCC). In fact, there are compelling reasons to categorise keratoacanthoma as a kind of invasive SCC.
  • Granuloma pyogenicum – Pyogenic granulomas are tiny, spherical skin growths that are usually crimson red in appearance. Because they include a great number of blood arteries, they tend to bleed. They’re also known as granuloma telangiectaticum or lobular capillary hemangioma.
  • Seborrhoeic wart – A waxy brown, black, or tan growth on the skin that is not malignant.
  • Solar Keratosis – Years of sun exposure have resulted in a rough, scaly spot on the skin.
  • Bowen’s disease – A red, scaly patch on the skin is the primary symptom. Squamous cell carcinoma in situ is a type of skin cancer that affects the squamous cells in the outermost layer of the skin.

Leave a Reply