Noah Sinclair
Lumps and bumps on fingers, wrists, and hands can be caused by various conditions, some of which may be serious. It is important to get an accurate diagnosis and appropriate treatment plan from an experienced healthcare provider or hand specialist. While many lumps and bumps may be harmless, some may indicate underlying medical conditions. For example, a myxoid cyst, also known as a digital mucous cyst, is a small, shiny lump commonly found near a nail on the finger or toe. On the other hand, acute paronychia is a bacterial infection causing pain, swelling, and redness around the nail, often due to an injury. Rheumatoid nodules, gout, and lipomas are other potential causes of lumps and bumps on the hands and fingers.
| Characteristics | Values |
|---|---|
| Diagnosis | Self-diagnosis is possible, but a doctor's evaluation is recommended for severe symptoms |
| Symptoms | Pain, swelling, redness, throbbing, warmth, pus, fever |
| Causes | Bacterial infection, diabetes, overaggressive manicuring, injury, arthritis, eczema, broken bones, gout, carpal boss, rheumatoid arthritis, Dupuytren's contracture |
| Treatment | Antibiotic ointment, soaking the finger in warm water, keeping blood sugar levels in check |
| Lump characteristics | Round or oval, firm or filled with fluid, small, shiny, skin-coloured, translucent |
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What You'll Learn
Paronychia
There are two types of paronychia: acute paronychia and chronic paronychia. Acute paronychia is a painful and purulent condition that usually develops suddenly, causing redness and swelling around a fingernail or toenail, usually after an injury to the area. It is most frequently caused by a bacterial infection, especially Staphylococcus aureus, Streptococcus pyogenes, or Pseudomonas. It can also be caused by the cold sore virus, Herpes simplex, or the yeast Candida albicans. Acute paronychia usually affects a single nail fold and lasts less than six weeks. Symptoms of acute paronychia include throbbing pain, swelling, and redness in an area of damaged skin around a nail. If left untreated, the nail can start to grow abnormally and may have ridges or waves. It may look yellow or green, and it can be dry and brittle. The nail can even detach from the nail bed and fall off.
Chronic paronychia is a gradual process that usually develops slowly, causing swelling, tenderness, and redness of the skin around the nails. It often affects several fingers on the same hand. It is usually caused by mechanical or chemical factors and sometimes infectious agents like a fungal infection, especially Candida species. It may start in one nail fold but can spread to several other fingers. Each affected nail fold is swollen and lifted off the nail plate, allowing the entry of organisms and irritants. The affected skin may be red and tender, and sometimes a little pus (white, yellow, or green) can be expressed from under the cuticle. The nail plate thickens and is distorted, often with transverse ridges. The main complication of chronic paronychia is nail dystrophy.
Treatment for paronychia depends on the type and severity of the condition. Acute paronychia can be treated by soaking the affected finger or toe in warm water several times daily. Topical antiseptics may be used for minor infections, while oral antibiotics may be necessary for severe or prolonged bacterial infections. Surgical incision and drainage may be required for abscesses. Chronic paronychia can be prevented by keeping the hands dry and warm, avoiding wet work, and wearing waterproof gloves when necessary. It is important to keep fingernails clean and to wash hands with soap and water after dirty work.
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Myxoid cysts
The cysts typically do not cause any pain, but they may be associated with arthritis pain and stiffness in the nearby joint. In rare cases, a myxoid cyst may grow under the nail, leading to nail deformities such as grooves, depressions, color changes, or nail splitting. This type of cyst can be particularly painful and may require medical attention.
The exact cause of myxoid cysts is not fully understood, but they are often related to underlying health conditions such as osteoarthritis. They are frequently found in individuals with osteoarthritis, with a prevalence of 64% to 93% in this population. Myxoid cysts are more common in adults aged 40 and older, with a higher occurrence in females compared to males.
While many myxoid cysts resolve without intervention, some individuals may opt for medical treatment if the cysts cause discomfort or cosmetic concerns. Surgical removal is the most effective treatment method, although it is not always necessary. Overall, myxoid cysts are a common and typically benign condition that can be managed effectively through various treatment options.
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Rheumatoid nodules
The same autoimmune response that causes RA also causes rheumatoid nodules. An overly active immune system can irritate tissue around the body, especially around joints that are used frequently. People with RA who use their hands a lot, such as those who work with tools, may be at higher risk of developing nodules around their fingers. Patients who develop nodules are more likely to be smokers and tend to have more severe rheumatoid arthritis. They are also more prone to other extra-articular features of rheumatoid, including vasculitis and lung disease.
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Lipomas
A bump where the skin meets the fingernail can be caused by a variety of conditions, including paronychia, myxoid cysts, and lipomas. While many lumps and bumps may be harmless, some can be signs of serious medical conditions, so it is important to get an accurate diagnosis from a doctor.
The clinical evaluation of superficial lipomas is accurate for diagnosis in up to 85% of cases, while radiological evaluation is diagnostic in up to 71% of cases. Computed tomography (CT) and magnetic resonance imaging (MRI) are helpful in assessing these lesions. Treatment for lipomas may involve excision, as in the case of a patient with a large lipoma on the middle finger who underwent a procedure with no postoperative issues and a full recovery of range of motion and sensation.
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Ganglion cysts
A bump where the skin meets the fingernail on the thumb could be a ganglion cyst. Ganglion cysts are the most common mass or lump that appears on the hand. They are fluid-filled cysts that arise out of a joint, like a balloon on a stalk. They are not cancerous and are usually harmless. Ganglion cysts can quickly appear, disappear, and change size. They can develop in several joints in the hand and wrist, but most often develop on the back of the wrist.
If you notice a bump on your thumb, it is important to get an accurate diagnosis from a doctor. They will be able to examine the bump and recommend a treatment plan. Treatment for ganglion cysts will depend on the underlying cause of the abnormality. Many ganglion cysts do not require treatment, but if the cyst hurts, affects function, or if you are unhappy with how it looks, there are several treatment options available.
A doctor may apply pressure to the cyst to test for tenderness or discomfort. They may also shine a penlight on the cyst to see whether light shines through, helping to confirm that the mass is a cyst and not a solid tumour. If the cyst is causing pain or discomfort, your doctor may recommend draining the fluid with a needle or, in some cases, surgery.
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Frequently asked questions
A soar bump where the skin meets the fingernail could be due to several reasons, including:
- Acute paronychia: a bacterial infection that occurs after an injury to the area, causing pain, swelling, and redness.
- Myxoid cyst: a small, shiny lump that can develop under the nail and is usually skin-colored and translucent.
- Ganglion cyst: a common lump that occurs within the hand and wrist, adjacent to joints or tendons.
- Rheumatoid nodules: firm lumps that grow under the skin as a symptom of rheumatoid arthritis.
Acute paronychia usually presents with sudden throbbing pain, swelling, and redness around the nail after an injury to the area. If you are experiencing these symptoms, it is important to seek medical attention, especially if you are diabetic or have severe symptoms such as pus, fever, or severe pain.
Myxoid cysts usually do not cause any pain and may go away on their own. However, it is recommended to consult a healthcare provider for an accurate diagnosis and appropriate treatment plan.
Yes, several other conditions can cause lumps and bumps on the fingers or hands, including:
- Carpal boss: a bone mass on the back of the hand where the finger bones meet the arm bones.
- Dupuytren's contracture: a thick, tight area of tissue on the palm at the base of the fingers that can cause the fingers to curl towards the palm over time.
- Lipomas: harmless fatty lumps found between the skin and underlying muscles.
