Differential Diagnosis for a Shin Lesion with a Whitish Scar

• Single most likely diagnosis
  • Eczema or contact dermatitis: This is a common condition that can cause lesions on the skin, including the shin area. The whitish scar could be a result of post-inflammatory hypopigmentation, which is a common sequela of eczema or contact dermatitis.
• Other Likely diagnoses
  • Psoriasis: This chronic skin condition can cause lesions on the skin, including the shin area. The whitish scar could be a result of the healing process of psoriatic plaques.
  • Nummular dermatitis: This condition is characterized by coin-shaped lesions on the skin, which can heal with a whitish scar.
  • Traumatic injury: A traumatic injury to the shin area can cause a lesion that heals with a whitish scar, especially if the wound was deep or became infected.
• Do Not Miss diagnoses
  • Squamous cell carcinoma: Although less likely, it is crucial to consider skin cancer in the differential diagnosis, especially if the lesion has an atypical appearance or has not healed as expected. A biopsy may be necessary to rule out this diagnosis.
  • Lupus vulgaris (cutaneous tuberculosis): This rare condition can cause skin lesions that heal with scarring, including a whitish scar. It is essential to consider this diagnosis, especially if the patient has a history of tuberculosis or has been exposed to someone with the disease.
• Rare diagnoses
  • Sarcoidosis: This condition can cause skin lesions, including those on the shin area, which can heal with scarring.
  • Lichen planus: This rare condition can cause skin lesions that heal with a whitish scar, although it is less common on the shin area.
  • Leprosy: This rare infectious disease can cause skin lesions that heal with scarring, including a whitish scar, although it is uncommon in most parts of the world.