DrAda:
Can we please end this squabble? In as much as I will like to conribute to this debate, I won't cos the answer is painfully obvious. THERE IS NO LYMPH NODE IN THE SCALP. Someone mentioned trichilemmal cysts otherwise known as wens. I saw that too, but thought twice about it cos the consistency is hard. I am thinking subcutaneous nodules?? Cause. Searched online and got these answers which in truth are no answers at all but close.


LESIONS OF THE SCALP:
Actual neoplasms of the scalp are quite rare in children, but congenital lesions of the scalp are rather common.
Two such lesions require special attention due to the known potential for malignant degeneration. Nevus sebaceous is a congenital lesion primarily of sebaceous glands of the scalp that may transform into basal cell carcinoma. Giant congenital compound melanocytic nevi may occur anywhere in the skin including the scalp. These nevi may give rise to malignant melanomas. Early prophylactic resection of these lesions is recommended to decrease the risk of future malignancy.
In practice, superficial lesions confirmed to the dermis are usually treated by dermatologists and plastic surgeons; it is not until subgaleal or cranial involvement is apparent that neurosurgical consultation is obtained. The following conditions, although not necessarily neoplastic, are frequently encountered by pediatric neurosurgeons.


Scalp Nodules
Subcutaneous nodules of the scalp are common in children. The majority do not possess any intracranial extension or any relation to the neural structures.7 However, lesions of the scalp that on palpation are found to be fixed to the skull, or those overlying the midline may require further neurosurgical evaluation.
Scalp nodules result from numerous processes. In children especially, enlarged lymph nodes may present as scalp nodules, particularly in the postauricular region. There is frequently a history of upper respiratory infection and the lymphadenopathv is self-limited. It is also not uncommon in children to notice very firm nodules fixed to the skull after trauma, with or without skull fracture. These periosteal reactions should also resolve spontaneously.
Multiple painless subcutaneous nodules of the scalp may result from an inflammatory process of unknown origin known generically as "necrobiosis." Necrobiotic granulomas of the scalp are described under man titles including rheumatoid nodules, benign rheumatoid nodules, pseudo-rheumatoid nodules, subcutaneous granuloma annulare, and subcutaneous palisadinggranulomas of the scalp. Histologically, necrosis and degeneration of dermal collagen is the predominant feature, surrounded by histiocvtes, epithelioid cells, and multinucleated cells.

In contrast to true rheumatoid nodules associated with rheumatoid arthritis, these granulomas involve the scalp and pretibial subcutaneous tissue and are not found near the joints. Progression to clinical rheumatoid arthritis does not usually occur. The lesions have a predilection for the occipital and frontal scalp and usually resolve spontaneously. In general, biopsy is not indicated in typically appearing lesions.

Neurofibromas of the scalp may accompany neurofibromatosis type 1 (NFl) and to a lesser extent, neurofibromatosis type 2 (NF2). With an incidence of 1 in 3,000 live births, NFl is a commonly observed condition in pediatric neurosurgical practice. In a patient with NFl or NF2, the discovery of painless, subcutaneous nodules of the scalp does not usually present a diagnostic problem. Occasionally, however, a nodule may be found in the absence of known neurofibromatosis. Characteristic cutaneous markings such café-au-lait spots and auxiliary freckling should be sought although they may not vet be present in young children. Biopsy of a lesion that shows neurofibroma, although not usually essential, may prompt consideration of the diagnosis of neurofibromatosis. Resection of neurofibromas of the scalp may be indicated when lesions are painful (e.g., in proximity to the occipital nerve) or disfiguring. Consideration of biopsy or resection should be made in neurofibromas that have rapidly enlarged because malignant degeneration is possible.

A variety of benign proliferative disorders of mesenchymal tissue occur in infancy and may result in masses involving the scalp. skull, and occasionally, the dura. These lesions are referred to by various terms and have excellent long term prognoses despite initial periods of rapid growth. Infantile myofibromatosis is characterized by diffuse or nodular proliferations of cells resembling fibroblasts and smooth muscle cells. Although considered the most common benign fibrous tumor of infancy, involvement of the scalp and skull is relatively rare. Some lesions appear to arise from the dura and result in significant intracranial mass effect although the brain and arachnoid are not invaded. In these cases, dural resection is recommended because recurrence may occur from involved dural.
Cranial fasciitis of childhood is a rare, benign lesion of unknown etiology that appears histologically similar to the more common nodular fasciitis and infantile myofibromatosis. It occurs predominantly in infancy and may present as a rapidly growing subcutaneous mass, often with intracranial or intraorbital extension. Operation is generally indicated for histological diagnosis and relief of mass effect. Despite an appearance alarmingly suggestive of malignancy, these lesions usually do not recur after removal.

Lagusta:


He would forever be a BOY to me unless he sheds that crappy attitude of his.....

DrAda:
Can we please end this squabble? In as much as I will like to conribute to this debate, I won't cos the answer is painfully obvious. THERE IS NO LYMPH NODE IN THE SCALP. Someone mentioned trichilemmal cysts otherwise known as wens. I saw that too, but thought twice about it cos the consistency is hard. I am thinking subcutaneous nodules?? Cause. Searched online and got these answers which in truth are no answers at all but close.


LESIONS OF THE SCALP:
Actual neoplasms of the scalp are quite rare in children, but congenital lesions of the scalp are rather common.
Two such lesions require special attention due to the known potential for malignant degeneration. Nevus sebaceous is a congenital lesion primarily of sebaceous glands of the scalp that may transform into basal cell carcinoma. Giant congenital compound melanocytic nevi may occur anywhere in the skin including the scalp. These nevi may give rise to malignant melanomas. Early prophylactic resection of these lesions is recommended to decrease the risk of future malignancy.
In practice, superficial lesions confirmed to the dermis are usually treated by dermatologists and plastic surgeons; it is not until subgaleal or cranial involvement is apparent that neurosurgical consultation is obtained. The following conditions, although not necessarily neoplastic, are frequently encountered by pediatric neurosurgeons.


Scalp Nodules
Subcutaneous nodules of the scalp are common in children. The majority do not possess any intracranial extension or any relation to the neural structures.7 However, lesions of the scalp that on palpation are found to be fixed to the skull, or those overlying the midline may require further neurosurgical evaluation.
Scalp nodules result from numerous processes. In children especially, enlarged lymph nodes may present as scalp nodules, particularly in the postauricular region. There is frequently a history of upper respiratory infection and the lymphadenopathv is self-limited. It is also not uncommon in children to notice very firm nodules fixed to the skull after trauma, with or without skull fracture. These periosteal reactions should also resolve spontaneously.
Multiple painless subcutaneous nodules of the scalp may result from an inflammatory process of unknown origin known generically as "necrobiosis." Necrobiotic granulomas of the scalp are described under man titles including rheumatoid nodules, benign rheumatoid nodules, pseudo-rheumatoid nodules, subcutaneous granuloma annulare, and subcutaneous palisadinggranulomas of the scalp. Histologically, necrosis and degeneration of dermal collagen is the predominant feature, surrounded by histiocvtes, epithelioid cells, and multinucleated cells.

In contrast to true rheumatoid nodules associated with rheumatoid arthritis, these granulomas involve the scalp and pretibial subcutaneous tissue and are not found near the joints. Progression to clinical rheumatoid arthritis does not usually occur. The lesions have a predilection for the occipital and frontal scalp and usually resolve spontaneously. In general, biopsy is not indicated in typically appearing lesions.

Neurofibromas of the scalp may accompany neurofibromatosis type 1 (NFl) and to a lesser extent, neurofibromatosis type 2 (NF2). With an incidence of 1 in 3,000 live births, NFl is a commonly observed condition in pediatric neurosurgical practice. In a patient with NFl or NF2, the discovery of painless, subcutaneous nodules of the scalp does not usually present a diagnostic problem. Occasionally, however, a nodule may be found in the absence of known neurofibromatosis. Characteristic cutaneous markings such café-au-lait spots and auxiliary freckling should be sought although they may not vet be present in young children. Biopsy of a lesion that shows neurofibroma, although not usually essential, may prompt consideration of the diagnosis of neurofibromatosis. Resection of neurofibromas of the scalp may be indicated when lesions are painful (e.g., in proximity to the occipital nerve) or disfiguring. Consideration of biopsy or resection should be made in neurofibromas that have rapidly enlarged because malignant degeneration is possible.

A variety of benign proliferative disorders of mesenchymal tissue occur in infancy and may result in masses involving the scalp. skull, and occasionally, the dura. These lesions are referred to by various terms and have excellent long term prognoses despite initial periods of rapid growth. Infantile myofibromatosis is characterized by diffuse or nodular proliferations of cells resembling fibroblasts and smooth muscle cells. Although considered the most common benign fibrous tumor of infancy, involvement of the scalp and skull is relatively rare. Some lesions appear to arise from the dura and result in significant intracranial mass effect although the brain and arachnoid are not invaded. In these cases, dural resection is recommended because recurrence may occur from involved dural.
Cranial fasciitis of childhood is a rare, benign lesion of unknown etiology that appears histologically similar to the more common nodular fasciitis and infantile myofibromatosis. It occurs predominantly in infancy and may present as a rapidly growing subcutaneous mass, often with intracranial or intraorbital extension. Operation is generally indicated for histological diagnosis and relief of mass effect. Despite an appearance alarmingly suggestive of malignancy, these lesions usually do not recur after removal.

DjSwaga:



Oya accept ur PhD already. Lmaooooo funniest post today

elobyobi:

Hi doc. I mentioned trichilemmal cysts because the OP didn't volunteer the consistency of the swellings, and trichilemmal cysts do calcify; whoever sent the OP to Union Diagnostics mentioned "calcified" somewhere in the indication for the x-ray....
But your stuff makes a lot of sense too. I guess it would be an interesting case to see up close. These nairaland people just come here to boast about who is a fellow and who is a medical student, it's tiring.

Lagusta:


My dear, please read my posts, see if I had any iota of ego protection in them....

If you noticed, I even wanted to playfully let everything slide, but he did the ultimate thing, he referred a senior to his textbooks. That is not only insulting but outright silly for a medical student to do....

At first, when he said "I hope those aren't lymph nodes" I didn't even correct him because I thought he was a doctor like me, so I just gave my opinion and left, then he started pouring out "stuff" for me, and I told him to compare his stuff to what he sees in the pic....

Even when he was still adamant, I just tried ignoring him. Then he had the effrontery and the audacity to say "go and read Cunningham" (which is even a manual of practical anatomy anyway)

I have mentored many medical students, created a thread for them, tutored students on how to survive, house officers on how to get stuff out of no stuff. None of them ever regretted it.....

Please don't misinterpret me please

ahkenaten:


I doubt if He is a doctor, nor a student. you can see how can someone forget some very basic things like scalp nodes and fluttering with trapezius muscle ?? the way he was even replying is funny. and still saying his source of rubbish is with held. Don't mind him jahre

DrAda:


I initially doubted if he was a doctor too until he mentioned the Ashkenazi Jews. I first learnt that term some years back when I was preparing for my primaries and found it intriguing that a group of people are genetically encoded to be plagued with multiple metabolic disorders. My guess is that he is a doctor without the clinical experience which he will gain with time. Also, I figured from his replies that at some point he knew that he made a mistake but didn't want to give up cos his ego was at stake. You guys didn't make it easy for him as well. I am glad it is over though.

Inshalord:
Good day all,

Please, I need your advice cos I believe before me people exist who have experienced this.
Doctors in the house abeg what could be d cause of this bumps,though we ve appointment with dermatologist next month 11th but also i will appreciate ur opinions before the appointed date.
Thanks

twinskenny:
Notice this on my sons head sometimes.... But used to disappear on its own. Then I noticed it comes up when he didn't barb his hair on time

djgreenland:
Even professors still consult their textbooks.....

Inshalord:
Good day all,

Please, I need your advice cos I believe before me people exist who have experienced this.
Doctors in the house abeg what could be d cause of this bumps,though we ve appointment with dermatologist next month 11th but also i will appreciate ur opinions before the appointed date.
Thanks.if u wil heed to ma advice,Go 2 to any branch of OPM n get d oil n water,or beta if u PH com to d headquaters on sunday get d oil n water daddy OPM wil bless it,use it to rub on d boy's head,i bet u it wil neva remain d same.

Inshalord:
Good day all,

Please, I need your advice cos I believe before me people exist who have experienced this.
Doctors in the house abeg what could be d cause of this bumps,though we ve appointment with dermatologist next month 11th but also i will appreciate ur opinions before the appointed date.
Thanks

Silkmoth33:
Hm! U did mention a human being(who was supposedly ur friend) that failed out of the Mbbs program.

I sure as hell hope that person was not vickybaba, cos d guy conjured up some trash from anywhere(as he is yet to understand what it means and paste here with a shrewed understanding) which u suprisingly agree with.

Stay away from such ppl, he has not helped ur situation at all. Pls do ur research on the nodes of the scalp and don't let this guy confuse u.

*But ppl wicked sha, how person go cite his own friend as example to teach moral lesson*

Silkmoth33:
Hm! U did mention a human being(who was supposedly ur friend) that failed out of the Mbbs program.

I sure as hell hope that person was not vickybaba, cos d guy conjured up some trash from anywhere(as he is yet to understand what it means and paste here with a shrewed understanding) which u suprisingly agree with.

Stay away from such ppl, he has not helped ur situation at all. Pls do ur research on the nodes of the scalp and don't let this guy confuse u.

*But ppl wicked sha, how person go cite his own friend as example to teach moral lesson*

Silkmoth33:


What can we say! the profession is like none other

kendraloops:



Exact situation with my son too!!

Flashaldrin:
Lmao! I really had a good laugh!. silkworth is probably one silly troll studying medicine in ukraine and laughing his arse off at how you guys are making so much fuss over his lame arse comments. Chief Lagusta and ahkenaten, you guys really have time o

And any body that thinks silkworth has ever been a doctor after all his scalp contains lymphnode, bone, muscles, and maybe even the brain bla bla should come for questioning.

He has potentials though that is if he is not mrcork's alternate moniker

Lagusta:


And you are....

Your point please....

But actually your post is quite amusing, considering the fact that the first doctor you would ever meet in the teaching hospital is the HOUSE OFFICER!!!

Cheers bro

Inshalord:
Good day all,

Please, I need your advice cos I believe before me people exist who have experienced this.
Doctors in the house abeg what could be d cause of this bumps,though we ve appointment with dermatologist next month 11th but also i will appreciate ur opinions before the appointed date.
Thanks

DrAda:


Now this is getting interesting.
My dear, those lesions can never be molluscum contagiosum. I have spent 6 years as a resident doctor in Paediatrics and I have seen quite a number of molluscum contagiosum cases and they don't look like that. I must say that I am rather surprised it was even considered as a differential diagnosis. Again @op, wait for the dermatologist. If you had come to me, that will be my advice. Those lesions don't look like it is of an infectious origin. An experienced dermatologist can make the Diagnosis just by inspection only. I have sent your kids pics to a dermatologist, expecting her reply.

Flashaldrin:
Lmao! I really had a good laugh!. silkworth is probably one silly troll studying medicine in ukraine and laughing his arse off at how you guys are making so much fuss over his lame arse comments. Chief Lagusta and ahkenaten, you guys really have time o

And any body that thinks silkworth has ever been a doctor after all his scalp contains lymphnode, bone, muscles, and maybe even the brain bla bla should come for questioning.

He has potentials though that is if he is not mrcork's alternate moniker

Silkmoth33:


beejay i admire your comeback. Good timing. Why do you ppl want me to talk to much. I'm almost a day old on the site and i already can conclude that this place is filled with "itk"s. Okay.

I'm a 400 level medical student at the premier private university in nigeria. So believe me when i say that unless you've got malfunctioning kidneys, syndrome of inappropriate hypersecretion of anti-diuretic hormone or secondary hyperaldosteronism; it is safe and hygenic to drink salt water.

okusman:



because an house officer is the first doc that will say hello to me doesn't mean he/she is the one that will treat me.... maybe I should put it in this format....

why don't you give the money that you want to deposit into your account to the security man that opens the bank door for u because he is d first staff of that bank to see/meet?...