The great majority of axillary swellings are enlarged lymph nodes. Axillary nodes are often enlarged due to secondary deposits from carcinoma of the breast. Most axillary swellings are easily diagnosed on clinical examination alone. This presents as a tender swelling in the skin. There may be a purulent discharge. Common in diabetics. A sebaceous cyst will present as a firm swelling in the skin, often with a punctum. It may be tender if it becomes inflamed and there may be discharge from it. This presents as a soft, lobulated swelling in the subcutaneous tissue. The patient may have noticed a lump in the axilla, which may be tender or non-tender. Check for a site of infection or malignancy in the region of drainage of the nodes, i.e. the arm, the chest wall and the abdominal wall as far down as, and including, the umbilicus, the skin of the back as far down as the iliac crest and the breast. Has the patient noticed any lumps elsewhere? Check for malaise, pyrexia, night sweats, cough. There may be a history of bruising or epistaxis to suggest a blood dyscrasia. Is there any evidence of scratches on the arm to suggest cat scratch disease?
Axillary Swellings
History
Superficial
Acute abscess
Sebaceous cyst
Lipoma
Deep
Lymphadenopathy (p. 321)
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Swellings
