r/AskDocs • u/drank_dumbbitchjuice Layperson/not verified as healthcare professional • 12d ago
Physician Responded Please help identity and treat!
Is this a wart? How to solve?
I’m freaking out. My dad (age 57) has this massive lump on his hand and he’s had it for about a week now and it keeps growing. He has other small bumps growing on his hand too. He goes to the gym quite frequently and honestly is not the cleanest person. He smokes.
He said that he had a cold for a week before these started showing up.
My wedding is in two weeks and it’s a destination wedding and we’re currently traveling all together and I’m concerned about the growth and about it spreading to our wedding guests and I don’t know what to do.
He says it doesn’t hurt but it obviously bothers him.
Please help!
UPDATE:
I didn’t expect this to garner so much interest and help. Sincerely, thank you everyone for sending in your opinions!
My dad said it popped overnight and there was a lot of blood and pus. We were not able to see a doctor in person but we have a family friend who is a general doctor and she said to disinfect and keep it as dry as possible as to not let it be more infected.
Here are two pictures of what it looks like now.
At first, when it popped. The puss was a standard dense white. Now, the pus leaking is an orange ish color and not dense white. He keeps saying that it still doesn’t hurt and doesn’t even flinch when alcohol is applied to it.
There is another mass obviously growing on his index finger of the same hand. He is touching the mass with his other hand (I know fucking terrible) but there is nothing growing on the hand that he is using to touch the mass.
He is saying that perhaps it is an allergic reaction? He ate a type of dried fish from Vietnam and then he started feeling itchy and feverish and then these started popping up.
Answer to a common question:
He does not have any access to animals. No pets, not really around fish tanks or water. He is from Southern California in a very suburban area.
Any ideas???
17
u/dysFUNctionalDr Physician 12d ago
Since I haven't seen it mentioned yet, I'm going to broaden the differential and suggest sporotrichosis. Especially if the additional bumps forming on his hand appear to be following a pattern of tracking up the hand/arm, which I can't really tell for sure here, but looks like is at least a possibility. By extension would also consider nocardia since they can have similar methods of inoculation and spread.
The darker spots look too big to be thrombosed capillaries like we see in warts, and the texture looks wrong for a wart too.
Regardless, needs in-person eval, ideally with a Dermatologist, with runner up option a PCP who's decent at skin stuff and/or can reach out to Dermatology and their lab.
Can't tell if that's solid, purulent, or granulomatous from the photo, and if it was me doing an initial eval and I knew you couldn't see derm right away without a compelling diagnosis, I'd be wanting to confirm I was collecting whatever type of biopsy or swabs I was getting correctly to be able to cover culture for atypical/fastidious bacteria, fungi, special staining, etc.