Summary about Disease
Nodular fasciitis is a benign (non-cancerous), rapidly growing, reactive proliferation of fibrous tissue that typically presents as a solitary nodule in the subcutaneous tissue. It is relatively rare and most commonly occurs in young adults, although it can affect people of all ages. It is often mistaken for a sarcoma (cancerous tumor), due to its rapid growth and histological features. The condition is self-limiting in many cases, and treatment often involves observation or simple excision.
Symptoms
A rapidly growing, solitary, firm nodule, typically 1-3 cm in diameter.
The nodule is usually located in the subcutaneous tissue (beneath the skin).
The most common sites are the upper extremity (especially the forearm), trunk, and head and neck.
The nodule may be tender to the touch, but is usually painless.
The skin overlying the nodule may appear normal, slightly erythematous (red), or bluish.
Causes
The exact cause of nodular fasciitis is unknown, but it is believed to be a reactive process, potentially related to:
Trauma: A history of minor trauma or injury to the affected area is sometimes reported, but this is not always the case.
Unknown Stimulus: In many instances, no specific triggering event can be identified.
Possible Genetic Factors: Recent research suggests that some cases are associated with specific gene fusions, indicating a possible genetic component.
Medicine Used
There is no specific medication to treat nodular fasciitis. Treatment focuses on symptom management and/or removal of the lesion:
Pain relievers: Over-the-counter pain relievers like ibuprofen or acetaminophen can be used to manage any discomfort.
Corticosteroid injections: In some cases, a corticosteroid injection into the nodule may be used to reduce inflammation and size.
Surgical Excision: The nodule is completely removed.
Is Communicable
Nodular fasciitis is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
There are no specific precautions to take to prevent nodular fasciitis, as the exact cause is unknown.
How long does an outbreak last?
Nodular fasciitis is not an "outbreak" in the traditional sense of an infectious disease. The nodule typically grows rapidly over a period of weeks (often 2-3 weeks), then may stabilize or even regress spontaneously over several months. Without treatment, it might persist for several months to a year, but it is generally self-limiting.
How is it diagnosed?
Diagnosis typically involves:
Physical Examination: Doctor checks the nodule size, location, and appearance.
Medical History: Doctor may ask about recent injuries or trauma to the area.
Imaging Studies: Imaging studies like ultrasound or MRI may be used to evaluate the nodule and rule out other conditions.
Biopsy: A biopsy (surgical removal of a tissue sample) is usually necessary to confirm the diagnosis. The tissue is examined under a microscope to rule out malignancy (cancer).
Timeline of Symptoms
Initial Phase (Weeks 1-3): Rapid growth of a small nodule.
Growth Phase (Weeks 3-6): The nodule reaches its maximum size (usually 1-3 cm).
Stable Phase (Months 2-6): The nodule remains stable in size, or may begin to slowly regress.
Resolution Phase (Months 6-12): The nodule spontaneously resolves (disappears) in some cases, although this is less common without treatment.
Important Considerations
Differential Diagnosis: Nodular fasciitis can mimic other soft tissue tumors, especially sarcomas. It is crucial to differentiate it from malignant conditions through proper diagnosis.
Psychological Impact: The rapid growth of the nodule can be alarming for patients, leading to anxiety and concern about cancer. Reassurance and accurate diagnosis are important.
Recurrence: Nodular fasciitis rarely recurs after complete surgical excision.
Consultation with Specialists: Diagnosis and treatment may involve consultation with a dermatologist, surgeon, and pathologist.