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Boils (Recurrent)

  • Obtain swabs

  • 3% hexachlorophane body wash daily

  • Mupirocin to the lesions and nares

  • Antibiotics (according to swabs), e.g. di(flu)cloxacillin 500 mg (o) qid for 7 d or cephalexin 500 mg qid for 5–7 d (may require up to 3 mths)

Table B3Breast lumps (women): diagnostic strategy model
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Table B3 Breast lumps (women): diagnostic strategy model

Probability diagnosis

Fibrocystic breast disease (mammary dysplasia) (32%)

Fibroadenoma (23%)

Cancer (22%)

Cyst (10%)

Breast abscess/periareolar inflammation

Lactation cyst (galactocele)

Serious disorders not to be missed

Vascular

  • thrombophlebitis (Mondor disease)

Infection

  • mastitis/breast abscess

  • tuberculosis

Cancer

  • invasive breast carcinoma

  • ductal carcinoma in situ

  • Paget disease of the nipple

  • sarcoma

  • lymphoma

  • mastitis carcinomatosa

Other

  • Phyllodes tumour

Pitfalls (often missed)

Duct papilloma

Lipoma

Mammary duct ectasia

Fat necrosis/fibrosis

Red flag pointers for breast lumps

  • Hard and irregular lump

  • Skin dimpling and puckering

  • Skin oedema (peau d’orange)

  • Nipple discharge

  • Nipple distortion

  • Nipple eczema

  • Postmenopausal women

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