"54542 Assessing the risk of subcutaneous nodules" by Rachel Krevh, Redina Bardhi et al.
 

54542 Assessing the risk of subcutaneous nodules

Document Type

Conference Proceeding

Publication Date

9-1-2024

Publication Title

J Am Acad Dermatol

Abstract

Subcutaneous nodules without identifying features are often observed by physicians during cutaneous exams, resulting in a wide differential. Diagnostic certainty is often implicated when practitioners overutilize the term “lipoma” for what they might deem as a benign-appearing nodule. Existing literature is limited when providing a standardized approach to the evaluation of subcutaneous nodules. Here, we outline five criteria to determine whether additional workup of subcutaneous nodules is indicated. We hope a simplified approach to assessing subcutaneous nodules may decrease unnecessary imaging for benign nodules and/or prompt further investigation of benign-appearing nodules that may be worrisome. Our study consists of a retrospective chart review of over 900 pediatric and adult patients from 2014 to 2022, using patient data from dermatology offices at Henry Ford Health. After reviewing charts that describe subcutaneous nodules, we obtained the following data: the size of the nodule, whether the nodule was mobile or fixed, duration, evolution, and associated pain. Benignity or malignancy was confirmed through histopathological diagnosis. Our results indicate a significant difference in the evolution between benign and malignant nodules (p<0.001), mobility (p<0.001), and size (p<0.001). Additionally, two or more malignant features (>3cm, immobile, painful, duration <1 year, rapid change) were observed in 19.1% of non-malignant patients versus 60% of malignant patients (p=0.008). Our findings suggest the malignant potential of subcutaneous nodules can be determined by evaluating relevant clinical criteria and calculating a malignancy score. These characteristics can aid in management by indicating when imaging or excisions are necessary, potentially mitigating harm from diagnostic delay.

Volume

91

Issue

3

First Page

AB18

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