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Why do my nerves bulge out when I go out in the sun?

Q: I am a 24 years old boy and have doubts regarding my physical appearance. I weigh just 52 kg and the nerves under my arms and hands are clearly visible. My nerves bulge out when I go out in the sun and I feel really embarrassed. Due to this, I have stopped wearing half sleeved shirts. There is no such problem when it’s not hot outside. My dad also suffers from the same problem. How do I treat this problem?

A:Your problem appears more like Neurofibroma, which is both a neurological and genetic problem. It results in benign tumours that arise from nerves. Neurofibromas usually affect nerves that are close to the surface of the body such as nerves of the skin or tissue just beneath the skin. The cause of neurofibroma is unknown. It sometimes occurs in patients with von Recklinghausen disease (neurofibromatosis). Patients may experience symptoms differently depending on the location and size of the tumour or tumours. Symptoms include: painless, slow growing mass, sometimes pain, electric like shock when affected area is felt (known as Tinel sign), usually no neurological problems or neural loss unless the tumour involves a major motor or sensory nerve or is compressed between the tumour and a rigid structure. Since the symptoms of a neurofibroma may resemble those of other medical conditions, you should always consult a doctor for the diagnosis. In addition to undergoing a complete physical examination and medical history, one or more of the following tests may be done: X ray- a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto a film. Neurofibromas are not seen well on x rays, but an x ray should be obtained to ensure that the adjacent bone is not involved. Ultrasound- an imaging technology that uses high frequency sound waves to view internal organs and structures and produce diagnostic pictures of the human body. Ultrasound is sometimes useful to detect soft tissue masses. Magnetic resonance imaging (MRI)- a diagnostic procedure that uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures within the body. Biopsy of the tumour- A simple surgical procedure during which a tissue sample from the tumour is taken and then viewed under a microscope. The exact treatment for neurofibroma may vary from person to person, depending on the patient's age, overall health and medical history. It has to be seen which nerves are affected and whether the condition is causing symptoms, patient's tolerance to specific procedures or therapies, how the treating doctor expects the disease to progress and your opinion or preference. If the neurofibroma is not involved with a major nerve, an operation to remove the nerve containing the tumour is usually the treatment of choice. If a major nerve is involved, doctors may choose to excise the tumour from the nerve, leaving the nerve itself intact, or leave the tumour alone, if it isn't causing any symptoms.


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