Differential Diagnosis for a Boggy and Ulcerated Lesion

• Single most likely diagnosis
  • Basal Cell Carcinoma (BCC): This is the most likely diagnosis given the description of the lesion as boggy and ulcerated. BCC is a common skin cancer that can present in various forms, including ulcerated lesions, especially in advanced stages.
• Other Likely diagnoses
  • Squamous Cell Carcinoma (SCC): SCC is another type of skin cancer that can present with ulceration and a boggy appearance, especially if it has become infected or has outgrown its blood supply.
  • Pyoderma Gangrenosum: This is a rare skin condition that can cause painful ulcers, which might feel boggy due to the significant tissue loss and inflammation.
  • Cutaneous Lymphoma: Certain types of cutaneous lymphoma can cause skin lesions that ulcerate and may have a boggy texture due to infiltration of malignant cells into the skin.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Merkel Cell Carcinoma: A rare and aggressive skin cancer that can present with ulceration and rapid growth. It's crucial to consider this diagnosis due to its high potential for metastasis and poor prognosis if not treated early.
  • Metastatic Disease: Although rare, metastatic lesions to the skin from internal cancers (e.g., breast, lung) can present as ulcerated and boggy lesions. Missing this diagnosis could have severe consequences.
• Rare diagnoses
  • Angiosarcoma: A rare and aggressive malignancy of blood vessel endothelial cells, which can present as a bruise-like lesion that ulcerates and might feel boggy due to its vascular nature.
  • Kaposi's Sarcoma: Especially in immunocompromised patients, this can cause skin lesions that might appear ulcerated and have a boggy texture due to the vascular proliferation and inflammation.