Painful Neck Growth in a 41-Year-Old Male: Furuncle and Skin Tag Removal
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we frequently evaluate patients with new or concerning skin growths. This case highlights a 41-year-old male who presented with a painful lesion on the back of his neck, as well as skin tags in the underarm area.
Patient Presentation
A 41-year-old male presented as a new patient with a growth on the posterior neck. The lesion had been present for 3 days and was initially painful. The patient had not tried any treatment prior to his visit.
He also noted multiple skin tags in the left axilla, which he wished to have removed.
Dermatologic Examination
A focused exam of the neck and left axilla was performed with the assistance of a dermatoscope. Findings included:
Furuncle (Boil): Inflamed, tender lesion on the posterior neck.
Skin Tags (Acrochordons): Multiple soft, pedunculated papules in the left axillary vault.
Impression and Plan
Furuncle
The lesion on the posterior neck was most consistent with a furuncle, a bacterial skin infection forming a small abscess.
Treatment Plan:
Doxycycline 100 mg taken orally twice daily for 10 days.
Mupirocin 2% ointment applied to the affected area three times daily for 10 days.
Supportive care: warm compresses with diluted vinegar solution, gentle cleansing with Hibiclens wash, and use of benzoyl peroxide.
Counseling:
Furuncles typically resolve with antibiotics but may occasionally require drainage.
If the lesion worsens or fails to heal, culture may be needed to rule out MRSA (methicillin-resistant Staphylococcus aureus).
Skin Tags
Ten skin tags in the left axilla were removed for cosmetic reasons.
Procedure:
Local anesthesia with lidocaine and epinephrine.
Removal performed using gradle excision.
Hemostasis achieved with Drysol.
Counseling:
Skin tags are benign but can be irritating when caught on clothing or jewelry.
Risks of removal, including bleeding, pigment changes, infection, or scarring, were reviewed with the patient.
Key Takeaway
This case demonstrates the value of dermatology evaluation for both infectious lesions (furuncles) and benign growths (skin tags). Early intervention with antibiotics and minor procedures can provide rapid relief and peace of mind.
At Village Dermatology in Katy and Houston, TX, we provide expert diagnosis and treatment of painful skin growths, infections, and cosmetic concerns.
