Hello richarduk,
My first thought is, have these cysts been biopsied to rule out
malignancy? Axillary cysts, or abcesses of the skin are quite common,
and usually are caused by clogged sebaceous glands, often due to a
minor cut during shaving, or an irritation from antiperspirants. Lymph
node swelling itself does not typically secrete fluid, and lymph nodes
themselves are not generally removed for anything other than a
malignancy. The function of the lymph nodes is to act as a filter,
trapping organisms in the process, helping to prevent a systemic
infection. When lymph nodes catch organisms, they swell. Some forms
of axillary lumps or swellings (not cysts) may be caused by bacterial,
fungal or viral infections, an antigenic reaction to a vaccine, or
some form of lymphoma. However, I would want to rule out any lymph
node malignancy before proceeding. Although rare, males can be
afflicted with breast cancer.
http://www.nlm.nih.gov/medlineplus/ency/article/003099.htm
Here is a good illustration of swelling seen in axillary lymph nodes:
http://health.allrefer.com/health/armpit-lump-swollen-lymph-nodes-under-arm.html
Please be aware that this answer that this answer is for informational
purposes only. It is not intended to replace medical advice from a
licensed physician, nor does it intend to diagnose or treat any
medical condition.
Bacterial folliculitis or furunculosis
===============================================================
Folliculitis or forunculosis is caused by a hair follicle that has
become inflamed or infected, occurring on the skin in areas of
increased friction. It presents with tender draining nodules, and is
treated with antibiotics such as Rifampin, Dicloxacillin or Septra,
along with Vitamin C. The area should be cultured prior to starting
antibiotic therapy to determine the causative organism. Superficial
lesions leave no scarring, but deeper pustules may scar the affected
area.
http://www.dermnetnz.org/index.html
http://merck.praxis.md/index.asp?page=bpm_report&article_id=BPM01DE09§ion=report&ss=1
Pilonidal cyst
===============================================================
Pilonidal cysts are abcesses that occur from an ingrown or dead hair
in the skin that is thought to create a small vacuum within the skin,
effectively ?sucking? in bacteria, causing an infection. However, upon
excision, only 50%$ of these cysts actually contain a hair! These
cysts, which occur 2.2 times more often in men than women, were once
known as ?Jeep Rider?s Disease because over 80,000 soldiers were
hospitalized with pilonidal cysts during WWII.
According to The University of Maryland, ?These cysts develop when a
dead hair or hairs are pushed into the skin forming a canal or
passage. This sinus then becomes infected as more debris collects in
the sinus. The most common place for a pilonidal cyst to develop is in
the skin over the tailbone, just over the cleft in the buttocks.
Friction and pressure on the area aggravate the condition along with
the presence of bacteria. People are not born with this condition but
develop it in the late teens, twenties or thirties. Trauma or injury
to the are may cause the cyst to become very tender and painful,
producing swelling and drainage.?
Treatment: ?A pilonidal cyst will be treated with antibiotics if the
area is infected. The cyst is usually opened and drained, and may need
to be packed with gauze for several days to weeks. Sometimes the
infected sinus may need to be surgically removed if the cysts recur or
if your surgeon feels surgical treatment is necessary.
Soaking in a warm, soapy or medicated bath may help ease the pain and
showering and cleansing the area may be prescribed. This will help
clean out the infected area. Tylenol or Motrin/Advil in recommended
doses may help with pain control also.?
http://pediatric.um-surgery.org/new_070198/new/Library/Pilonidal%20Cyst.htm
http://www.emedicine.com/emerg/topic771.htm
Treatment, according to eMedicine:
oConservative management includes incision and drainage of the abscess
or sinus, packing, surgical follow-up, and improved hygiene. This
approach leads to good results and low recurrence rates.
oAfter the skin is infiltrated with local anesthetic, an adequate
incision is made, lateral to the midline, and care should be taken to
search for all sinus openings.
oThe contents, including hair and granulations, are evacuated, and
then area is irrigated with copious amounts of fluid.
oHemostasis is achieved with pressure and packing.
oAntibiotics are not necessary in most cases and should never be the
primary mode of treatment. Antibiotic treatment may supplement
incision and drainage in the infrequent case with cellulitis.
http://www.emedicine.com/emerg/topic771.htm
This could indeed be hidradenitis suppurativa,(HS) as the commenter
ac67-ga noted below.
Hidradenitis suppurativa
======================================
Hidradenitis suppurativa consists of boils, abcesses, lesions of the
lymphatic nodes, that drain pus, and heal slowly, usually over 10-30
days, and may reoccur several times a year. HS affects the axillae
(armpits), the areola of the nipple, groin, circumanal, and
periumbilical regions, and is more common in females,
African-Americans, the obese, and those who have tightly curled hair,
as ingrown hairs can trigger an outbreak. Excessive heat, or
conditions that increase perspiration can aggravate or trigger HS.
Because HS seems to be related to sex hormones (testosterone,
estrogen), it is not seen in patients who have not yet reached
puberty. Hidradenitis suppurativa is uncommon in New Zealand, but
fairly common in the US, and its cause is not totally known. Although
HS exists as a primary condition, it may be seen secondary to
irritable bowel syndrome, Crohn?s Disease, Down Syndrome, herpes, some
forms of arthritis, and Grave?s Disease.
Treatment consists of one or several of the following:
Maintaining the armpit as clean as possible, using antibacterial cleansers
Short course of antibiotics such as Flucloxacillin or dicloxacillin
(Ruling out penicillin alleregy first)
Incision and drainage of abscesses - when at a head
Several months of tetracycline or metronidozole
A 6-12 month course of treatment with isotretinoin
Corticosteroids
Excisional surgery for very severe cases only
Anti-inflammatory drugs, such as Naprosyn or ibuprofen may be helpful
Oral birth control pills may be used in some patients to regulate sex hormones
From eMedicine, ways to deter outbreaks:
·Minimize heat exposure and sweating.
·Lose weight if overweight.
·Avoid constrictive clothing and frictional trauma.
·Avoid underarm antiperspirants and deodorants
http://www.dermnetnz.org/index.html
http://www.emedicine.com/emerg/topic259.htm
http://www.aocd.org/skin/dermatologic_diseases/hidradenitis_suppu.html
http://www.skinsite.com/info_hidradenitis_suppurativa.htm
Hope this helps you! The symptoms you have described are not exclusive
to the conditions I have listed above. There are numerous other
possibilities, that without diagnostic tests would be impossible to
accurately diagnose.
If any part of my answer is unclear, please request an Answer
Clarification, before rating. This will allow me to assist you
further, if possible.
Regards,
crabcakes
Search Terms
Axillary cysts
Lymph node cysts
Lymph abcesses |
