How do I differentiate cobblestone throat from other possible causes of bumps at the throat? (photo)

Thanks for the very helpful picture. Your condition is typical of moderate to severe acne, due to the presence of active pimples, acne scars and comedones (or blackheads). The dark coloured, bigger lumps that you described is an infected cyst – the reason why it’s tender, swollen and dark coloured, is because your body mounts an inflammatory response to the clogged pores and trapped bacteria; similar to how your other pimples are formed.

Thank you for the question. Unfortunately, I think the picture is not clear enough for a proper assessment. In general, if the bump is due to a pimple, it will come and go and is not usually persistent. A cyst or a malignant growth is usually persistent and may slowly increase in size. It is best for you to see your doctor for a proper assessment if the bump is persistent.