Bumps in Fingers

Dear Lisa,

What could it be if I have bumps on my fingers inside the skin when I touch them they move and sometimes hurt?

“Advice?”,

Dear “Advice?”,

Without physically examining your fingers it is not possible to tell you exactly what these bumps are. Typically a small bump under the skin that moves with palpation is a nodule. A nodule is defined as a solid mass that is less than 1 cm in diameter and extends deep in to the dermal layer of the skin. (1) A nodule under the skin can develop because of a variety of reasons. In order to determine the cause of your “bumps” you will need an evaluation by your Physician who is familiar with your health and knows your past medical history.

The location of a nodule on your finger would need to be known in order to determine the possible causes. Nodules found near the cuticle area may be a sign of a developing skin infection, especially if redness or nail biting is involved. On the other hand, nodules found over the joints may be found in patients with Rheumatoid Arthritis. Children suffering from Rheumatoid Arthritis with RF positive bloodwork are more likely to develop Rheumatoid nodules.(2) Rheumatoid nodules are firm, non-tender, subcutaneous nodules located around the joints in the fingers.(2)

Subcutaneous nodules may also be found in patients with Rheumatic Fever. The subcutaneous nodules found in Rheumatic Fever can be found over the joints and are more common in those patients suffering from severe Carditis. (1)

Dermatofibromas, although typically found in young adult women, may also occur in the pediatric population. This type of nodule is usually asymptomatic, but may be itchy and tender in some people. Dermatofibromas are more commonly found in the lower extremities and the cause is unknown.

It is important to remember when inspecting the skin that it is more than a covering of the body. The skin is an organ and a complex system serving many functions. The skin protects the body against trauma, regulates temperature, serves as a mechanical barrier to infection, as a sensory organ, stores chemical compounds, synthesizes vitamin D and excretes water, salts and several organic compounds. (3) Many systemic diseases and infections present with cutaneous lesions or skin changes. Therefore any persistent rash, lesion or finding should be evaluated by a physician in order to determine its cause.

References:
(1)Bellack J, Bamford P. Nursing Assessment A multidimensional approach. Belmont, CA:Wadsworth Inc.1984:298.
(2)Betz C, Hunsberger M, Wright S. Family-Centered Nursing Care of Children. 2nd ed. Philadelphia, PA:W.B.Saunders Company. 1994:1594.
(3)Tortora G, Anagnostakos N. Principles of Anatomy and Physiology. 4th ed. Sao Paulo, Sidney:Biological Sciences Textbooks, Inc. 1984

Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Pediatric Health Advice