What is the cause of a painful white mole (melanocytic nevus) on the face that is tender to touch?

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Differential Diagnosis for a White Mole Under the Face that Hurts when Touched

  • Single most likely diagnosis:
    • Milia: A small, white bump that can appear on the face, often due to keratin buildup. It can be tender to the touch, especially if it becomes inflamed or infected.
  • Other Likely diagnoses:
    • Epidermoid cyst: A benign cyst that can appear as a small, white lump under the skin, which may become painful if inflamed or infected.
    • Sebaceous hyperplasia: A benign condition characterized by small, white or yellowish bumps on the face, which can be tender if irritated.
    • Keratosis pilaris: A condition that causes small, rough patches on the skin, which can sometimes appear white and be sensitive to touch.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Basal cell carcinoma: Although less common, a basal cell carcinoma can present as a pale or pearly nodule, and it's crucial to rule out this possibility due to its potential for local destruction if left untreated.
    • Squamous cell carcinoma: This type of skin cancer can sometimes appear as a firm, white nodule, and early detection is vital for effective treatment.
  • Rare diagnoses:
    • Pilomatrixoma: A rare, benign tumor of the skin that can appear as a firm, white nodule, often on the face.
    • Syringoma: A rare, benign tumor that can cause small, white or yellowish bumps on the face, which may be tender to the touch.
    • Trichoepithelioma: A rare, benign tumor that can appear as a small, white nodule on the face, which may be sensitive to touch.

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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