Comments on: What to do if you discover a lump

By: Alan Greene

Alan Greene — Sat, 17 Aug 2013 19:32:00 +0000

Thank _you_ Dawn. And for your important work!

By: Dawn Winkelmann

Dawn Winkelmann — Sat, 17 Aug 2013 02:22:00 +0000

OMG this video was so informative! I constantly have swollen lymph nodes and my doctor always talks about surgery, but then it goes away. I am so thankful to know it’s just my body working against infections. Since I work with kids 12 hours a day, I fight infections a lot!

Thanks Dr. Greene!

Dawn Winkelmann, M.S,CCC-SLP
Speech Pathologist/Feeding Specialist

By: Alan Greene

Alan Greene — Fri, 16 Aug 2013 19:45:00 +0000

My pleasure! Great question.

By: Emily Hamblin

Emily Hamblin — Fri, 16 Aug 2013 19:44:00 +0000

Many Thanks, that has put my mind at ease.
Emily

By: Alan Greene

Alan Greene — Fri, 16 Aug 2013 19:27:00 +0000

Lisa Anne, most - but not all - neck lumps turn out to be fine. Here's my guide on when to be concerned and take a child to a doctor. When you're concerned, it's never silly to ask your doctor! In fact, it's the responsible thing to do.

By: Alan Greene

Alan Greene — Fri, 16 Aug 2013 19:20:00 +0000

Hi Emily,

A common benign finding in uncircumcised boys is something called smegma or a preputial cyst. It’s just extra old skin cells that collect in a pocket because the foreskin isn’t fully retractible yet. These are usually well-delineated, and sometimes pearly white under the skin. They actually help the separation of the foreskin and the glans of the penis, and are squeezed out on their own once the foreskin becomes easier to retract. Nothing needs to be done for this in the meantime.

Phimosis is the name of not being able to retract the foreskin. There is both normal phimosis and phimosis that should be treated.

Normal phimosis is present in almost all newborn boys. The opening is soft and pliant, but doesn’t retract much. While there is usually some movement by age 2, in only about 8% of normal uncircumcised boys does it fully retract by 1st grade. This typically eases up on its own, as you’ve said. There’s no rush at all. Most are fully retractible by 7th grade.

I’ve written about the care and cleaning of an uncircumcised penis here: http://www.drgreene.com/qa-articles/cleaning-penis-intact-foreskin/

Circumcision isn’t needed for normal phimosis or for smega/preputial cysts. Gentle, but not forcible, manipulation can be okay.

With problem phimosis, the opening is usually hard, or scarred, or has a white ring. You may see frequent infections, ballooning, urinary problems, or new tightening after it used to be loose. A pediatrician or pediatric urologist can help to diagnose this.

Thanks, Emily, for looking into this for your son.

By: Lisa Anne Davies

Lisa Anne Davies — Fri, 16 Aug 2013 10:40:00 +0000

My daughter is 2 years and has a lump in her artery in her neck. (I say artery, it is the main blood vessel on her right). It is raised and very noticeable when she shouts or screams. My husband has noticed it also are we are concerned but feel a little silly taking her to the doctor. She had colic as a baby due to lactose interlerance and spent 15 hours a day screaming and I’m not sure whether it has been caused by that. It was fairly noticeable since she was about 3 months old.

By: Emily Hamblin

Emily Hamblin — Fri, 16 Aug 2013 06:47:00 +0000

Hi Dr Green
My son has just had his 2nd Birthday this week. He has a lump on his penis – about half way down the shaft and under the skin (it doesn’t move when you move the skin over it). It is quite well deliniated but is soft rather than hard. It has been growing for about 6 months. I have now taken him to 2 doctors. Both have said that it is not something to worry about. the first said it was a sebacious cyst, the second said smegma. (not sure if these are the same). The second said that he needs to have a circumcision as it is there because his foreskin is too tight and I ought to be manipulating it to ease it up. She wants to circumcise him in 6 months. I thought that it was normal for the foreskin to be tight at this age and that it shouldn’t be manipulated that it would ease up on its own? He doesn’t have ballooning or infection surely circumcision should be a last resort?