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10 Years Ago I Had A Small Bump Removed From

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Posted on Tue, 2 Oct 2018
Question: 10 years ago I had a small bump removed from my back, near my spine. It was mostly painless but eventually became painful after years. It was marble sized or less. I believe if was diagnosed as a cyst, but this removal was done at an urgent care clinic, so I’m not sure if any pathology was done.

Recently, within the past few months, I’ve felt it grow back. During the past few weeks I’ve noticed that it grew back and has become painful when pressure applied to it. I went to the same urgent care clinic (too difficult to get a dermatologist appointment). The doctor said it was probably a cyst, cut into it, said it was “a little but pusy, “packed” it, applied a dressing, gave me a prescription for a 10 day course of Bactrim, said to return in a few days to have the packing removed, and advised to follow up with a dermatologist or a surgeon in case the “core” was not removed.

So, I have several questions.

1) Based on this description, does this indeed sound like a cyst? (I will try to attach a photo of the pre-removal lump). In other words, should I be concerned that it is something cancerous like a liposarcoma?

2) Is the fact that the original procedure, 10 years ago, was also performed at urgent care clinic a possible reason why the growth grew back? That is, the “core” was not removed?

3) Regarding Bactrim. I am not sure if i have a sulfa-drug allergy. I don’t believe I do, and I may indeed have taken a sulfa drug before without incident. I simply can’t remember. Is this drug truly necessary under the circumstances? I am traveling out of the country to propose to my girlfriend in less than a week—I am concerned that I will develop a rash by then and, obviously, this will not be ideal for the occasion (or for international travel).

Thanks in advance.
doctor
Answered by Dr. Dr. Kakkar (55 minutes later)
Brief Answer:
Regarding sebaceous cyst on the back

Detailed Answer:
Hello and Welcome to Ask A Doctor service.
I have reviewed your query, as well as the images and here is my advice...

It is definitely like a sebaceous cyst. Back is a common site. A sebaceous cyst can persist for years and may either remain static or increase ever so closely in size. It may recur after a seemingly incomplete removal wherein a part of the lining wall is accidentally left over. Bacterial superinfection is the most common complication of a sebaceous cyst.

Even though the risk of a drug reaction is a remote and unpredictable one, if you are wary of taking sulpha drugs I would suggest another option for an oral antibiotic e.g a penicillin-like either Amoxicillin or Cephalexin for a week (you may need to obtain the prescription from your local physician).

It would be better to take any one of these oral antibiotics because the cyst had become painful/ infected prior to it was removed.

Hope I have answered your query.
Let me know if you need any more assistance.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Kakkar (1 hour later)
Thanks very much for your quick response.

I’ve already taken a single dose/pill of the Bactrim. If I discontinue now, would this reduce the likelihood of adverse reaction?

Additionally, are these other classes any less effective for this purpose?
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Follow up: Dr. Dr. Kakkar (4 hours later)
And on the other hand, what is the real risk of taking no antibiotic at all? I would prefer to not need anything due to the general antibiotic GI side effects. If I take nothing, can I still minimize risk of infection?
doctor
Answered by Dr. Dr. Kakkar (11 hours later)
Brief Answer:
Regarding oral antibiotics

Detailed Answer:
Hi.

If you have already begun.. I advice you to continue with sulpha/bactrim. Adverse reactions can happen to any drug. Some can happen on taking the first dose itself and some can happen even days after stopping the drug. Penicillin group is equally good for skin and soft tissue infections but adverse drug reactions can happen to penicillin group too. If your surgeon has asked you to take oral antibiotics then you must take it because he must have felt the need for it. Moreover since the cyst was already infected when it was operated so even I think taking oral antibiotics is a fair thing to do. Ideally oral antibiotics should have been given for a week and the cyst should have been operated after the infection had resolved.

Take care
Let me know if you need any more assistance
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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10 Years Ago I Had A Small Bump Removed From

Brief Answer: Regarding sebaceous cyst on the back Detailed Answer: Hello and Welcome to Ask A Doctor service. I have reviewed your query, as well as the images and here is my advice... It is definitely like a sebaceous cyst. Back is a common site. A sebaceous cyst can persist for years and may either remain static or increase ever so closely in size. It may recur after a seemingly incomplete removal wherein a part of the lining wall is accidentally left over. Bacterial superinfection is the most common complication of a sebaceous cyst. Even though the risk of a drug reaction is a remote and unpredictable one, if you are wary of taking sulpha drugs I would suggest another option for an oral antibiotic e.g a penicillin-like either Amoxicillin or Cephalexin for a week (you may need to obtain the prescription from your local physician). It would be better to take any one of these oral antibiotics because the cyst had become painful/ infected prior to it was removed. Hope I have answered your query. Let me know if you need any more assistance.