From Mystery Bump to Diagnosis – A Young Woman’s Dermatology Journey in Katy & Houston, Texas
By Dr. Caroline Vaughn
Introduction
At Village Dermatology in Katy and Houston, Texas, we frequently see patients concerned about new or changing skin lesions. While many skin bumps are benign, proper evaluation is crucial to ensure accurate diagnosis and treatment. In this case report, we highlight a 23-year-old woman’s experience with a persistent chest lesion and an unexpected facial rash—showcasing our patient-centered approach and expertise in general and medical dermatology.
Case Overview: Chest Lesion Evaluation
Chief Complaint: A brown lesion on the chest, present for six months, recently inflamed.
A healthy 23-year-old woman came to our clinic in Katy for a first-time dermatologic consultation. Her main concern was a moderately pigmented bump on her lower sternum that had started showing signs of inflammation within the past week. She had never received prior treatment and was understandably anxious about the sudden change in the lesion’s appearance.
Expert Examination & Diagnosis
Our board-certified dermatologists conducted a comprehensive skin exam, using a dermatoscope for close evaluation. Based on the lesion's location, features, and recent inflammation, two potential diagnoses were considered:
Epidermal Inclusion Cyst (EIC): A benign sac filled with keratin that can become inflamed or rupture.
Inflammatory Papule: A more general term for a raised, inflamed lesion.
After discussing treatment options and risks with the patient, including the possibility of surgical excision or anti-inflammatory therapy, she opted for a Kenalog (ILK) injection—a minimally invasive solution with minimal downtime.
Treatment Administered:
Intralesional Kenalog (ILK) Injection: 4.0 mg/cc (0.1 cc total volume).
Counseling: Education on lesion care, potential outcomes, and signs that warrant follow-up.
Unexpected Diagnosis: Perioral Dermatitis
During her visit, the patient also mentioned a facial rash she had been managing on her own. Our exam revealed redness and inflammation around the mouth and cheeks, characteristic of Perioral Dermatitis—a chronic inflammatory skin condition.
Treatment Plan:
Topical Metronidazole 0.75% Cream: To be applied nightly.
Lifestyle Modifications: Avoiding cosmetic products, using non-comedogenic skincare, and protecting the skin from wind and sun exposure.
Patient Education: Triggers such as steroid creams, certain toothpastes, and environmental factors were discussed.
Follow-Up & Outcomes
We scheduled follow-ups at:
4–6 weeks for the chest lesion post-ILK.
6 months for reassessment of Perioral Dermatitis, with a backup plan for doxycycline therapy if needed.
This dual-case highlights the importance of seeing a qualified dermatologist—even for what seems like a “simple bump.” Accurate diagnosis, patient education, and personalized treatment are pillars of dermatologic care at Village Dermatology, serving Katy and Houston, TX.
Why This Matters in Katy & Houston, Texas
In growing urban and suburban communities like Katy and Houston, patients often delay seeing a specialist. This case underscores how early evaluation by an experienced dermatologist can save time, reduce anxiety, and lead to effective, tailored treatment plans. Whether you're dealing with a puzzling bump, persistent rash, or just want peace of mind, our team at Village Dermatology is here to help.
