hi! thanks for sharing your health concerns with HCM! If someone with patchy hair loss and scalp lump comes to me, I divide the disease into two parts: 1. fungal infection causing scarring alopecia on the surface 2. a sebaceous cyst or lymph node which is a lump under the skin therefore, for confirmation of the diagnoses, you need a microbiological test from the surface and an FNAC from the underlying lump; before going for therapy! Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.