Second Opinion

[chris294]

I have a soft lump under my left armpit only.  I have these raised, itchy red bumps around the lower back of my spine and left waistline. I was treated for scabies by my physician, and changed my bedding, etc. but it did not go away.  I am also very itchy around my groin area, but not my sexual organs. This has been going on for about 3 months now.

I also get night sweats or hot flashes that last about 3 - 4 hours that accompany a red rash that spreads up my front torso to my lower neck line in the evening between 9PM - 12PM. My doctor has scheduled me to take a CAT and MRI scans, and do a biopsy of my lymph node under my armpit.  What do you suspect this could be?

[Fernando Roque, MD]

Hi.  That soft lump under your left armpit may be an enlarged lymph node, what is called "reactive lymphadenopathy".  Lymph nodes, which are actually aggregates of white blood cells, usually enlarge as a reaction to a nearby infection or inflammation.  Your enlarged armpit node is most probably a reaction to the skin infection/ inflammation you're currently experiencing.  

Has the doctor actually proven the diagnosis of scabies? If not, then maybe skin scrapings need to be taken to look for mites or eggs.  A lot of other conditions can present as rash, itching and hot flashes, and the reason your symptoms haven't gone away may be because they have been misdiagnosed as scabies, but are actually some other condition.

How large is that armpit lump by the way?

[chris294]

The lump under my armpit is 3" long by 1" wide. It does not hurt when I press and freely move my hand around the lump and it is not hard. I had a CT scan done this past Thursday and will meet with my doctor to see the results on Monday.  My doctor will also have me do an MRI scan before he does a biopsy.  I noticed yesterday another lump is beginning to form on my other armpit.  

My doctor has already concluded I do not have scabies, since the antibiotics do not make the rash, itching, and hot flashes go away.  Do you think the hot flash could be caused by an increase in body temperature to combat an infection?  Do lympoma's also cause these same symptoms?  

Thank you for your help!  

[Fernando Roque, MD]

Hi.  Yes, the hot flashes can be one of the symptoms of infection.  It is also possible for malignancy like lymphoma to cause such symptoms.  I agree with your doctor's decision to have a biopsy of that armpit lump done.  It seems too large to just be "reactive lymphadenopathy".  Anyway, I do hope the biopsy doesn't turn out anything serious.  Good luck.