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I've had a tender bump on the front of my lower leg just left (outside) of the shin bone for approximately 3 weeks. I first noticed it in bed when moving my leg against the sheet (I felt a little tenderness when rubbing the leg against the sheet). I looked at my leg and noticed a bump a quarter inch or so in size in the spot I described. It seemed to just show up out of the blue. It wasn't red, itchy or warm but it was a little tender/painful when I pressed on it. I had virtually the same type of bump about 4 and 1/2 months ago in the same spot -- lower front leg near shin on the outside of the shin. I thought it was on the same leg then too (left leg) but I checked an old note sheet from that time and I had written that it was on the right lower leg near shin. So, I'm confused now. I'm not sure which leg it was on 4 and 1/2 months ago. I do know I don't have any bumps in this area on the right leg today. At that time, I thought it might have been a bug bite because I remember getting bit in the lower leg while sitting at a table on my backyard deck a couple days before noticing the bump. When I felt the bite, it hurt more than a typical mosquito bite. I tried to slap the bug on my leg but never saw any bug (mosquito, spider, whatever). I don't know if that first bump had anything to do with a bug bite or not. The first bump, 4 and 1/2 months ago, seemed to go away in about three weeks. I used a hot wash cloth compress a couple times a day, some topical Neosporin, and a salve mixture of powdered Vitamin C and liquid Vitamin E (and some hot baths). I've done the same thing this time only not as religiously-- i.e., off and on treating it with a hot wash cloth and Neosporin or Aloe Vera gel or Vit C and E salve and then nothing for a couple days. One day I put hyrocortisone cream on it but never followed up with that because I didn't know if that made any sense or not. This time I think I irritated it pretty good and that's why it's lingering. Here's how I irritated it: I read something on the Internet where this could be a "muscle knot" or "muscle spasm" and if you pressure it, it might dissipate. Well, it felt kind of like a tight muscle knot so I pressed really hard on it for several minutes one day. That succeeded in making it more sore, flattened the bump some, made the area red and more painful and a couple hours later I noticed some pretty good swelling in that area. A couple hours after that the swelling was down again and a day or two later the redness was basically gone. So, I must have caused some inflammation. Needless to say, I haven't put any heavy finger pressure on it since and the symptoms have been much better. That was 10-14 days ago. Since then I've just treated it off and on with the hot wash cloth and sometimes Neosporin, sometimes Aloe Vera gel. At any rate, it's been much better since the day I put the finger pressure on the bump. Since the day I first noticed it approximately three weeks ago, I would say it's a little less tender upon pushing on it slightly and the bump seems a tad flatter (which happened after I put the heavy finger pressure on it). The only time the symptoms got worse was the day when I put a lot of pressure on it. Otherwise, I would say the symptoms are slightly better than three weeks ago -- but there is still a bump there and it is still a little tender/painful when pushing on it a little. The tenderness/pain isn't bad at all, only if I push on the bump or bump it. Since the day I pushed hard on the bump, it seems flatter and a tad wider. Healthwise, I feel fine, same energy; same activities. I have been jogging 5-6 days a week, etc. It doesn't really seem like a bug bite. I'm guessing it could be an obstructed sweat gland or hair duct or something. Maybe the obstructed sweat gland or hair duct got infected a little. Or maybe it's a cyst that got traumatized a little and flared up... (sebaceous or epidermoid cyst?) I thought it might be Erythema Nodosum because those bumps tend to be on the front of the shins but most descriptions of that say the bumps are reddish and then after a couple weeks it looks like a bruise (purplish). Also, That's not the case for me. It seems to be better (bump seems a little smaller and flatter and less tender/painful) on the days I wash it regularly and use a hot wash cloth compress a couple times a day. I've just been lazy about doing that regularly because I've been thinking it's about gone. I washed it and then put a hot wash cloth on it again this morning and it seems to feel better (flatter and less tender to the touch. Based on the fact it went away last time following this regime, it probably would improve more quickly if I used warm/hot compresses two or three times a day for a week or so, and maybe aloe vera gel, Neosporin, VitC/VitE salve or hyrocortisone cream after the compress ... At any rate, thank you for your thoughts
Thank you for the photographs. Its hard to comment without actually feeling the lesion but my first possibility would be an irritated sebaceous cyst. A follicular cyst is the second possibility. Both of these will not subside on their own but are harmless and can be left alone. Treatment involves removal through a small nick.I'd be happy to answer any further queries you may have.
You're most welcome. I'll address your questions one by one:1) What do you mean by "removal by a small nick"?Ans. This is a small surgical incision about half an inch in length through which the cyst is removed intact.2) I had basically the same thing on my lower leg about 4 and 1/2 months ago and it appeared to disappear completely after 3 weeks or so. However, in that case, I didn't irritate it by using heavy finger pressure on the bump, or by putting a very hot heating pad on it. I think those two things have made this bump linger. Isn't it possible that if I don't irritate this and give it mild, basic treatment (like keeping it clean, applying a warm wash cloth occasionally, and maybe a Vitamin E/Vitamin C ointment) that it will subside and go away?Ans. Yes I was going to suggest this - that is if the bump subsides on its own then its unlikely to be a cyst and could be something like infection of the hair follicle. You could apply an OTC antibacterial cream like Bacitracin ointment over the bump for 14-21 days and see if that helps.I read some about sebaceous cysts on the Internet and saw an article that said that a warm compress can help the material in the cyst break away and be absorbed by the bodyAns. Occasionally sebaceous cysts can resolve on their own. More often they persist. Warm compresses have no role to play in the resolution though.3) Do you think factors like stress, diet and hygiene could be factors in these types of cysts/irritations? I have been under a lot of stress lately (lost my job), my diet hasn't been the greatest and although I shower regularly, I have to admit that I don't use soap and a wash cloth on my lower legs on anything close to a regular basis. I've had boils before and found them connected to stress, diet and hygieneAns. Yes boils can be related to hygiene and stress but boils are pretty obvious things and you would know it from the pain on touching it and it would be quite warm as compared to the normal skin. Cysts on the other hand are not related to the factors you mentioned.Hope this helps!
Morning,Any thought as to why when I put heavy finger pressure on this cyst/follicular infection that it got worse (more tender/painful, more red, more swelling, etc.) and then when I stopped that it improved?Ans. This is common with cysts as they tend to get irritated by manipulation or external pressure. The same thing can happen with an infection.Also, the one day I put a hot heating pad on it for 15 minutes or so, it got more red in a circular area around the bump and the bump might've got a little bigger as well. When I stopped this, it got better too. Could this have been from irritation or inflammation from the hot pad? When I just use a warm wash cloth for a few minutes I don't get this reaction (that I did from the hot heating pad for 15 minutes).Ans. The increase in redness is due to increase in local blood supply as heat causes vasodilation - that i increase in the size of the blood vessels temporarily. A heating pad would cause this much more than just a warm wash cloth.