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Differential Diagnosis for a 9-year-old boy with a raised circular nodule

Single most likely diagnosis

  • Dermatofibroma: A common, benign skin growth that can appear as a firm, raised nodule, often resulting from minor injury, insect bite, or other skin trauma. The history and physical examination are usually sufficient for diagnosis.

Other Likely diagnoses

  • Wart: Caused by the human papillomavirus (HPV), warts can present as firm, raised nodules. They are contagious and can spread through skin-to-skin contact.
  • Molluscum contagiosum: A viral skin infection that causes small, pearly, or flesh-colored bumps. It's contagious and spread by direct contact with the skin lesions.
  • Keloid or hypertrophic scar: These can appear as firm, raised nodules, especially if the child has a history of skin injury or surgery.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed)

  • Skin cancer (e.g., melanoma): Although rare in children, it's crucial to consider, especially if the nodule has irregular borders, multiple colors, or is rapidly changing.
  • Insect bite or sting reaction: Certain reactions, like those to ticks or certain spiders, can cause significant morbidity if not promptly treated.
  • Lymphoma (cutaneous T-cell lymphoma): A rare type of cancer that can initially present with skin lesions.

Rare diagnoses

  • Xanthoma: A rare skin condition characterized by the accumulation of excess lipids in cells, leading to firm, raised nodules.
  • Neurofibroma: Associated with neurofibromatosis type 1, these are benign nerve sheath tumors that can present as firm, raised nodules.
  • Leishmaniasis: A parasitic infection spread by sandflies, which can cause skin lesions that may appear as firm, raised nodules, especially in travelers to endemic areas.

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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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