Armpit Lump

[Timoteo]

Hello, Doctor--

Within the past four weeks, I have engaged in protected sex with two women who have numerous sexual partners (escorts).  I'm not writing to discuss the relative risk involved, but I have been worried about a lump under my right armpit that I found today.

I found it accidentally when showering.  I wanted to ask about "armpit lymph node swelling."

Question ONE:  

     Part ONE:  My impression is that swollen lymph node in the armpit are supposed to be deep in the armpit (i.e., in the hollow of the armpit?  Is that true?

This lump feels like the size of a pea.  It's painful to touch (even the slightest touch hurts).  When I poke it, even slightly, it causes pain into the elbow!

It's very superficial.  I barely have to touch my armpit to find the lump.  In other words, it't not deep in the armpit in the "hollow of the armpit.  

In fact, the lump feels like its right in the muscle of the armpit.

The skin covering this bump also feels like a little swollen.


Question TWO:  Is one swollen lymph nodes = ARS?  I hear that swollen lymph nodes can indicate HIV ARS.

Question THREE:   Also, I know you can't see it, and diagnose a swollen armpit lump, but does it sound like a lymph node?  

-Timoteo

[caine]

Well, I'll ask the question in a few of these forums to see if I get a response...  BTW, this fourm has kept me from literally jumping off of a building in guilt and fear!

Simply put I had a lump appear (just one at first) under my right arm.  Just that arm and nothing else, no other symptoms... actually I feel great (might be the vitamins!)  At first nothing and then a head appeared and I did what (almost) everyone does, I popped it!  I squeezed until the pus ran out, then applied Neosporin and gauze and left it at that.  Three days, no more raised lump and I thought the problem was gone.  I heal pretty fast, and if I feel that something doesn't heal quickly something wrong i.e. a cold or flu lasts for me maybe two days so I'm pretty healthy.  

A week later not one or two but three lumps, one large (about the size of a dime) and two smaller lumps painfully reappear underarm.   Now I'm an optimist so this might not even be a lymph node thing, but these lumps hurt enough for me to wonder aloud what could be wrong?  They're painful, not severely, but painful nonetheless and my best advice (from Mother Nurse) is that SHE believes its my lymph nodes and that I should be on antibotics.  I have had an abcess within the lower gums of my mouth before and she believes this might causing it...

My guilt is that I had sex with a female who I'm sure is promiscuous, the condom broke (never use Durex or whatever brand clinics give out) AND she's pretty oblivious about her own sexual history...

I'll see a clinic within the week, but I just had to comment about how much (mis-)information is out there and I must say that this forum has stopped my extremist mind from keeping me up tonight, and put some sanity back into my questions instead thinking the worst...

[artma2004]

Hi, Doctor:

I know you are exhausted of lymph node questions, so this will be a one-line question:

When a lymph node swells up (e.g., does not very quickly, and thus causes pain) during ARS, will the skin "over" (i.e., covering) the lymph node ALSO be somewhat swollen?  

End of Question! :)

[H. Hunter Handsfield, M.D.]

I can't say more from your description (or from any online description) than I already have.  People should not go poking around looking for lymph nodes; leave that to a knowledgeable healthcare provider.

In my reply above, I wrote "HIV-related lymph nodes are nontender".   How can I be more clear?  Since I didn't qualify it further, it obviously applied to all stages of HIV infection, including ARS.

You need to see a healthcare provider.  I can't help further.

HHH, MD

[Timoteo]

Dear Doctor:  I intended to include a brief 3rd point, but neglect to do this.  Please excuse my negligence.  

Just for my education:

1. So, if I had swollen armpit lymph nodes would such swollen lymph nodes be found by "poking" into the hollow of the armpit, AND NOT by simply touching the muscular part of the armpit (which is what I have.)

2. Skin lesion. So, a skin lesion can cause a bump under the skin? But like I said it's a superficial bump, just right below the skin, but in the muscular part of the armpit.

3.  You state that lymph node swelling is not tender.  Is this the case for lymph node swelling due to HIV-ARS (the actue HIV infection stage that can happen 2-4 weeks after infection)??


Thanks you,

Timoteo

[Timoteo]

Just for my education:

1.  So, if I had swollen armpit lymph nodes would such swollen lymph nodes be found by "poking" into the hollow of the armpit, AND NOT by simply touching the muscular part of the armpit (which is what I have.)

2.  Skin lesion.  So, a skin lesion can cause a bump under the skin?   But like I said it's a superficial bump, just right below the skin, but in the muscular part of the armpit.

Thanks you,

Timoteo

[H. Hunter Handsfield, M.D.]

Clearly it isn't a lymph node.  Nodes are deep under the skin; this sounds like a skin lesion.  HIV-related lymph nodes are nontender, and as you say, there always are many of them, not just one.  Sounds more likely to be a cutaneous infection of some sort, maybe folliculitis pimple, etc.  See a healthcare provider if it persists, or immediately if it grows, gets more tender, you have fever, etc (these are signs of potentially serious bacterial infection, not HIV), and not in any way HIV related.

HHH, MD