Lesions of the Hand

This page was last reviewed 13-08-20

Ganglia are firm, fluctuant and occasionally tender cystic swellings emanating from the joints of the wrist and hand or flexor tendon sheaths, which frequently fluctuate in size. There is a genetic predisposition, but they may be associated with pre-existing arthritis or previous trauma. Discomfort attributed to the cyst may in fact be related to underlying joint pathology. The cyst may rupture spontaneously but troublesome lesions can be repeatedly aspirated or surgically excised under local or general anaesthetic or regional block. Although aspiration is rapidly effective and can be performed in the outpatient clinic, it carries a very high rate of recurrence. However, even surgical excision is associated with relatively frequent recurrence. See RefHelp page on Ganglia

Other firm subcutaneous swellings that occur in the hand include the benign Giant Cell Tumour (GCT), epidermal inclusion cysts, neuroma and vascular lesions, each with distinct characteristics, signs and symptoms.

The dorsal skin of the hand is a common site for benign lesions to occur, including simple naevi, age-spots and dermtofibromas as well as pre-cancerous lesions such as actinic keratoses.

Malignant lesions are also common on the skin of the hand but are rare in the subcutaneous tissues. They include Basal and Squamous Cell carcinoma, and more rarely Malignant Melanoma.