Differential Diagnosis for Rough Raised Brown Lesion

Single Most Likely Diagnosis

• Seborrheic keratosis: This is a common, benign skin growth that often appears as a rough, raised brown lesion, particularly in older adults. Its appearance and prevalence make it the most likely diagnosis for this description.

Other Likely Diagnoses

• Melanocytic nevus (mole): While typically smoother and more pigmented, some moles can present with a rough texture and brown color, making them a plausible consideration.
• Dermatofibroma: These are small, hard bumps that can be brown in color and have a rough texture, often resulting from minor injury, making them another possible diagnosis.
• Keratoacanthoma: A low-grade, or sometimes considered benign, tumor of the skin that can appear as a firm, rough, brown lesion, although it's less common than seborrheic keratosis.

Do Not Miss Diagnoses

• Melanoma: Although less likely, melanoma can present in various ways, including as a rough, raised brown lesion. Given its potential deadliness, it's crucial not to miss this diagnosis, even if the appearance doesn't perfectly match the classic "ABCDE" criteria.
• Squamous cell carcinoma: This type of skin cancer can sometimes appear as a rough, brown lesion, especially in sun-exposed areas. Its potential for metastasis makes early detection critical.

Rare Diagnoses

• Merkel cell carcinoma: A rare and aggressive skin cancer that can appear as a firm, painless nodule, which might be brown in color, although it's less commonly described as rough and raised.
• Cutaneous metastasis: In rare cases, metastatic cancer from other parts of the body can appear in the skin as rough, raised lesions, including brown ones, though this would be highly unusual without a known primary cancer.