My reflection on managing uncertainty started after a young patient consulted following my referral to the plastics team for a small 1-cm diameter lump on the flexural surface of his right mid-forearm. The lump looked benign and had been there for about 3 weeks.He said it started similar to the sequelae of an insect bite; it was mildly tender and had grown a little bigger. Could it be a furuncle, carbuncle, abscess, sebaceous cyst, lipoma or wait? It was mobile, but fixed to the skin above it. The skin surface was smooth and there was no punctum. It bothered the patient so I had referred him. Plastics didn't make anything of it and discharged the patient back to me. The patient was still concerned to know what this lump was, but I didn't have an answer. I reassured him and gave safety netting advice: If you detect changes in skin colour, discharge, worsening pain, an increase in size over a short period of time or similar lumps appear elsewhere, then come back for further assessment.
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