What is the diagnosis for two painful lesions on the back of the head that have remained unchanged in size for one week?

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Differential Diagnosis for 2 Painful Bumps on the Back of the Head

  • Single most likely diagnosis
    • Folliculitis: This is an inflammation of the hair follicles, often caused by bacterial or fungal infections. It presents as painful bumps or sores, which matches the patient's symptoms. The fact that the bumps are not changing in size and are not spreading suggests a localized infection.
  • Other Likely diagnoses
    • Furuncles (Boils): These are localized skin infections, usually caused by Staphylococcus aureus, that can appear as painful bumps. They can occur on any part of the body, including the back of the head.
    • Abscesses: Similar to furuncles, abscesses are collections of pus that can cause painful bumps. They can be caused by bacterial infections and may require drainage.
    • Ingrown Hair (Follicular Cyst): If the patient has curly hair, an ingrown hair could cause a painful bump, especially if it becomes infected.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
    • Meningitis or Subdural Abscess: Although less likely, it's crucial to consider central nervous system infections, especially if there are signs of neurological deficits or systemic illness. These conditions can present with headache, fever, and localized pain.
    • Osteomyelitis: An infection of the bone, which could potentially occur in the skull and cause localized pain and swelling.
  • Rare diagnoses
    • Kerion: A severe form of tinea capitis (ringworm of the scalp), which can cause painful, swollen areas on the scalp.
    • Erythema Induratum: A rare condition characterized by recurring painful nodules on the scalp, often associated with tuberculosis.
    • Cutaneous Metastasis: In rare cases, cancer can metastasize to the skin, presenting as painful bumps or nodules. This would be extremely rare and usually occurs in patients with known primary cancers.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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