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Forum Name: Pediatric Topics

Question: 11 yo son has pea-sized lump on chest...


 justamom - Tue Dec 12, 2006 1:24 pm

Last week, my 11 yo old son developed some red, raised, itchy and painful patches on his chest/underarm area, left side. I didn't think anything of it until yesterday when he showed me a hard, pea-sized lump in that area. It's above and about 1-2 inches to the left of his left nipple. It doesn't hurt and doesn't move around. He has no other symptoms. He is small for his age, and recently has experienced a decrease in appetite and is easily fatigued.

Should I be concerned? Does this warrant a doctor's visit?

Thank you for any help!
 Dr. Safaa Mahmoud - Tue Dec 12, 2006 9:04 pm

User avatar Hello,

Direct clinical examination is essential for the diagnosis.

These lesions could be due to one of the following causes:

- Friction and fungus are very likely to be the causes of these symptoms since it occurs in an area where skin rubbing against skin is highly frequent.
Skin rubbing against skin generates heat and sweat, fungal growth in turn lead to , redness and , painful Itchy patches (tinea).
The Itch may progress into inflammation and becomes more complicated.

- Contact Dermatitis occurs due to skin contact with a substance that causes an allergic reaction (allergic contact Dermatitis)
or with an irritant substances (irritant contact Dermatitis).
There are many causes for contact Dermatitis some involve irritants such as soaps, certain creams and some may be due to allergy.
Avoiding the causing substance is the mainstay of prevention in addition to medications prescribed by your doctor.

The other new small swelling could be a lymph node, which occurs as a reaction to the inflamed skin lesions that may be also affected by secondary bacterial infection.

I advise you to follow with his doctor for proper management.
Keep us updated.
Best regards.


-
 justamom - Tue Dec 12, 2006 10:02 pm

Thank you very much for your prompt and thoughtful reply. You are doing a wonderful work by volunteering your service and I greatly appreciate it! May you be blessed.

I took my son to the dr today and he saw a nurse practitioner. As soon as he lifted his shirt she said it was Shingles. The lump is a lymph node doing its job as you indicated in your reply. She prescribed Acyclovir, which he started this afternoon.

Isn't it unusual for a child to have shingles? I was very surprised. It seems as if there should be some cause, such as some immune deficiency, in someone so young and otherwise healthy. The NP did not discuss this, however, and in fact didn't really seem surprised at all. My son is experiencing pain at the rash site, and just generally seems down.
 Dr. Safaa Mahmoud - Wed Dec 13, 2006 8:14 am

User avatar Hello,

Thank you for updating us, It is true, Herpes zoster is infrequently seen in healthy children, but it is possible to occur in children who have had chickenpox within the first year of their lives.

Follow up with your doctor is essential.
Best regards.

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