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Lump on the palm, hard, blue black, painful under pressure. Suggestion?

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Internal Medicine Specialist
Practicing since : 1998
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I am a male, 52 years old, 5'10", 190 lbs., non smoker, non drinker, and in good health. About 3 weeks ago, I noticed a lump on the palm of my left hand. The lump is now 8 mm in diameter, is hard, and blue-black in color. I have not had any puncture wound in the area and the skin surface looks fine. The area around the lump is not puffy, swollen, or sensitive. The lump is painful when pressure is applied. What do you recommend I do?
Posted Sat, 21 Apr 2012 in Skin Hair and Nails
Answered by Dr. Jasvinder Singh 15 minutes later

Thanks for posting your query. This bump on the palm of hand can be a blood blister, pyogenic granuloma or a hemangioma.

Pyogenic granuloma is a benign growth that often appears as a rapidly growing, bleeding bump on the skin and is composed of blood vessels. Blood blisters are caused by a rupture of the blood vessels underneath the skin’s surface.

Wash the lump frequently in order to keep it clear of irritants. Applying zinc cream to the area can also help dry up the lump and speed the healing process.

Elevate the hand, give rest to the part, apply cold compresses,soak the blister in Epsom salt and keep the hand bandaged so as to avoid its rupture. If the lump breaks, quickly rinse the area and apply an antiseptic such as Neosporin so as to prevent any infection.

If the symptoms worsen then the other two possibilities of pyogenic granuloma or hemangioma (both benign growths of blood vessels) need to be ruled out. Physical examination and biopsy can confirm the diagnosis.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Lump on the palm, hard, blue black, painful under pressure. Suggestion? 18 hours later

In my description, I said that the skin's surface is fine. The lump seems to be about 4 to 6 mm below the surface. I don't understand your recommendations to wash it, apply cream, etc. since it is not a "blister". I looked at pictures of pyogenic granuloma and hemangioma and my condition is not that. I've had blood blisters directly below the skin surface before and this problem is not that. Any other thoughts?
Answered by Dr. Jasvinder Singh 47 minutes later

Thanks for writing back and thanks for the clarification.

From these symptoms it looks like a hematoma under the skin of the palm. Hematoma is a collection of pooled blood in a small space on the back or palm of the hand and presents as small lump which can be blackish blue in color and tenderness is often present.

Apply warm compresses on the lump and take some anti inflammatory analgesic like Ibuprofen or Diclofenac after consulting your doctor.

Eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs.

A small hematoma goes away on its own after warm compresses; but if the symptoms persist then you may need to get it drained from a doctor.

Also then other possibilities of a benign skin growth under the skin and dupuytren's contracture (although less likely from your symptoms) need to be ruled out.

You can also send me the pics of the lesions on your hands to YYYY@YYYY with sub as ATTN to Dr. Jasvinder Singh. I will be able to take a look at them and suggest you better.

Hope this answers your query. I will be happy to answer your further queries.

Wishing you good health.


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