November 2021: Fleshy Lumps on the Scalp

Nausea and body aches. Probably COVID. Unvaccinated. Definitely COVID. After all, what else are we seeing?The 20-something young man was eating and talking on his phone. He passed the look test. His vitals were pristine, but he regaled me with myriad symptoms he had had for months. He hadn't taken any medicine. I was at a loss for what drove him to come to the emergency department. He thought for a minute and said, "I want to know why I have all these."He pointed to a spot on his head, which drew my attention to a fleshy lump. Then he moved his hair around, causing others to appear. "You can feel lots more," he said.My first thought was neurofibromatosis, but the lesions were concentrated on the scalp and nowhere else. He said he had only noticed these since the beginning of the pandemic. He was told during a previous ED visit that it was an abscess, and he received antibiotics. Now he had bumps all over his head. I had never felt so many lesions in my life.It is COVID times, so we tested him for COVID, but this didn't sound like COVID at all. In fact, I wasn't sure what it was. Did the wide constellation of complaints signal an intracranial process? To the donut of truth.​No intracranial abnormality was seen, but present were multiple subcutaneous cystic lesions on the scalp, which may have reflected cutaneous manifestations of systemic disease or numerous sebaceous cysts. The radiologist wondered if he could have Gardner syndrome.Thoughts of Gardner sy...
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