Differential Diagnosis for Round Lesion on Skin with Central Divot

• Single most likely diagnosis
  • Molluscum contagiosum: This is a common viral infection that presents with small, round, and pearly lesions with a central divot or umbilication. The lesions are often multiple and can be found on various parts of the body.
• Other Likely diagnoses
  • Keratosis pilaris: This is a benign skin condition characterized by small, round, and rough lesions that can have a central depression, often found on the arms, legs, and buttocks.
  • Seborrheic keratosis: A benign growth that can appear as a round lesion with a central divot, often found on the face, chest, and back.
  • Wart: Some types of warts, such as flat warts or plantar warts, can present with a central divot or depression.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Basal cell carcinoma: Although less common, basal cell carcinoma can present as a round lesion with a central divot or ulceration. It is essential to consider this diagnosis, especially in sun-exposed areas or in individuals with a history of skin cancer.
  • Squamous cell carcinoma: Similar to basal cell carcinoma, squamous cell carcinoma can present with a central divot or crater, and it is crucial to rule out this diagnosis, especially in high-risk individuals.
• Rare diagnoses
  • Trichoepithelioma: A rare benign tumor that can appear as a round lesion with a central divot, often found on the face.
  • Pilomatrixoma: A rare benign tumor that can present as a round, firm lesion with a central divot or depression, often found on the face, neck, or arms.
  • Metastatic skin cancer: In rare cases, metastatic skin cancer can present as a round lesion with a central divot, and it is essential to consider this diagnosis in individuals with a history of cancer.