Dermatologist or hand surgeon?

[thekarens]

I've met my ridiculously high deductible for the year, so I've decided to do all the things I've put off or whatever.

Anyway, I've got a bb size lump under the pad of my right thumb. It's been there about 10 years. You can't see it, but if you press there you can feel it and it hurts under direct pressure.

I mentioned it to my gp when it first appeared and she told me not to worry about it, that I had probably injured the finger at some point.

Which brings me to now. I want to get it taken care of and have the lump removed. I just don't know who to see, dermatologist or hand surgeon?

Thoughts/advice?

[smittykitty]

I vote surgeon. Derms don't specialize in leaving the smallest scar.

[OakLeaf]

I don't know that I have a clear understanding of what it is, but if it's scar tissue, I'd want to be very sure that surgery won't just make it worse, and I wouldn't necessarily trust any surgeon (dermatological, orthopedic or other) to give me an honest answer to that. If it's bothering you, maybe ask your PCP what she'd recommend. If you're very sure it's just some kind of defect in the skin and it's not too near a joint, maybe a plastic/reconstructive surgeon. A hand surgeon is an orthopedist, so they'd be the one to consult if it's on or near a functional structure like a joint or tendon. I think your instinct is right though that a dermatologist would probably have the best ability to look at your existing scars and draw conclusions about the way your body forms scars.

[thekarens]

I actually have no idea what it is. Back then my gp said don't worry about it so I didn't. Knowing better now I would have had it investigated, but that ship has sailed.

It's no where near a joint. It's right in the center of the pad of my thumb under the skin and it feels about the size of a bb. You can't see it looking at my thumb, but you can feel it. I want it removed because it causes pain when I press on it.

[emily_in_nc]

I would probably start with a dermatologist first. S/he should be able to advise if another kind of surgeon would be better for it, but since the skin is an organ, even the deeper layers are things a dermatologist should be well-versed in. Good luck to you!

[thekarens]

Thank you to everyone for your advice! I see my derm tomorrow anyway so I'll ask her. I also made an appointment with a hand/ortho specialist. If the derm says she can handle it I will cancel my other appt with the hand doc.

[Catrin]

Good luck with your decision - hope it provides you relief!

[thekarens]

Well, those who pick hand surgeon win this round. Went to the derm since I wanted her to freeze some warts anyway and she said she thinks it's a ganglion cyst and she actually recommended the doc I had already made an appt with. She also said I could ignore it if I wanted, but since it causes me grief and I've met the deductible I'm going to take care of it.

[ny biker]

Well at least you had other reasons for seeing the dermatologist, so it wasn't a wasted visit.

Years ago I ended up meeting a high deductible thanks to surgery to remove a mysterious lump on my shoulder blade that ended up being just a benign bone growth. I took advantage of the situation and had several large moles removed.

Good luck with the hand surgeon.

[thekarens]

Just an unrelated side note, did you know the "home remedy" for ganglion cyst is smash it with a book? Seriously! Ow! My partner offered to do that for me. No thank you!

I never in my life would have believed I'd meet a $3400 deductible. Before this year I wouldn't have even met a $500 deductible. It certainly puts things in perspective.

[Pax]

I've had a ganglion cyst in my wrist since I was a teenager, my doc told me the same thing about using a book... really not something you should tell a teenager. BTW, it didn't work.

[thekarens]

I've had a ganglion cyst in my wrist since I was a teenager, my doc told me the same thing about using a book... really not something you should tell a teenager. BTW, it didn't work.

I'm sorry, I know it's not funny, but I did have to laugh at the absurdity of a doc telling a teen that and of course a teenager would have to try it. There's no way I could willingly hit it hard enough to pop it.

[Pax]

I'm sorry, I know it's not funny, but I did have to laugh at the absurdity of a doc telling a teen that and of course a teenager would have to try it. There's no way I could willingly hit it hard enough to pop it.

It totally cracks me up in retrospect, my friends and I in the lunchroom in high school, a big old history text book, WHAM "did it pop" no... lets try again. God were were so stupid!! LOL

[OakLeaf]

Ow!!!!!

Hope you can get it taken care of soon ... WITH numbing!

[Blueberry]

One of my friends had a ganglion cyst surgically removed from her wrist. It was bugging her - and she was glad she had it done! Good luck with the surgeon!

[thekarens]

Surgeon says it could be a couple of things, but most likely a ganglion. Chopping will commence on the 16th. She only does surgeries on Thursdays and she's out next week.

She gave me the choice of a local or the kind that makes you loopy but doesn't put you completely out. I voted for local.

Then she said we'll call you with how much you owe at the time of service and I was out of there. That all took about 2 minutes and $340. Thankfully since I've met my deductible I only had to pay $17.

[Sharon N.]

Has anyone mentioned a glomus tumor? I had one removed from the pad of my thumb last Spring. It feels like a small lump, is quite painful when your finger gets cold and is extremely painful if you accidentally strike your thumb against something, especially hitting the thumb nail itself.

Even though it's called a tumor it's not cancerous, but it can grow back after removal if they do not get it all out. Glomus rumors are not very common. I've been a RN for 27 yrs and had never heard of it until I started searching the Internet with my symptoms. My hand surgeon quickly confirmed the diagnosis.

[thekarens]

Thanks for the information Sharon. I ended up waiting on the surgery as my insurance decided the doc is out of network and I haven't gotten around to finding another one yet.