XLarge fluctuant interdigital swelling / cyst

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Hi All

Can anyone identify what this very soft fluctuant interdigital swelling is?
Afro-Caribbean lady 58 yrs old, no medical history admitted. slightly over weight, non smoker, no sign of PAD/PVD. No local wounds or trauma reported, no signs or symptoms of infection, not painful no pain at all in local area. Normal skin cover, not translucent, no odour or discharge. Onset 4 months and has grown steadily since then to present size.
No fluid could be aspirated or expressed from the mass but the largest syringe needle I have in surgery is 27 gauge so it wouldn't draw up synovial fluid anyway but then again this felt too soft to be synovial fluid.

I have referred to GP to be cautious but I haven't seen a lump quite like this before and can find no reference like it in my Dermatology manuals




Cheers Dave

 

http://www.tevak.org/pdf/dergi/2012/pdfsno1/23_1_52_54.pdf

 

Brilliant, that looks like the chappy thanks Bel I knew you'd come to the rescue.
Have you ever excised a Lipoma as large as this? I don't think I would be confident to do it. I'm interested to know how do others deal with this lesion.

Regards Dave

 

I hate to disappoint

Best to refer to Pod or plastic surgeon for excision, IMO. Histopathology is required with any `oma` to rule out anything more sinister, such as liposarcoma.

Have a good weekend, Dave :drinks

Bel

 

Excise it. This excision, however, may be complicated and need some skin excision to make it more cosmetic. Either a well-trained podiatric surgeon or a plastic surgeon would be the first choice for surgical referral if you don't feel confident enough to do it yourself.

 

Yes my sentiments exactly which is why I referred to GP

Dave