Differential Diagnosis

• Single most likely diagnosis
  • Multiple Familial Trichoepitheliomas: This condition is characterized by the development of multiple skin tumors, often on the face, which can regress spontaneously but may leave scars. The family history of similar lesions and their behavior supports this diagnosis.
• Other Likely diagnoses
  • Basal Cell Carcinoma (BCC): Although BCCs are common facial skin tumors, their rapid growth and spontaneous regression are less typical. However, the location and family history could suggest a genetic predisposition to skin cancers.
  • Keratoacanthoma: These are rapidly growing lesions that can regress spontaneously, often leaving a scar. Their appearance on sun-exposed areas like the nose and cheek, along with the described behavior, makes this a plausible diagnosis.
• Do Not Miss
  • Squamous Cell Carcinoma (SCC): Although less likely due to the spontaneous regression, SCC can be aggressive and metastasize. The rapid growth of the nasal lesion warrants consideration of this potentially deadly diagnosis.
  • Merkel Cell Carcinoma: A rare but aggressive skin cancer that can grow rapidly and has a high risk of metastasis. Its occurrence on sun-exposed areas and rapid growth rate make it a critical diagnosis not to miss.
• Rare diagnoses
  • Brooke-Spiegler Syndrome: A rare genetic disorder characterized by the development of multiple trichoepitheliomas, cylindromas, and spiradenomas. The family history and type of lesions could suggest this syndrome, although it is less common.
  • Rombo Syndrome: Characterized by atypical facial nevi, hypotrichosis, peripheral vasodilation with cyanosis, and a high risk of basal cell carcinoma. The presence of facial lesions and a possible family history might suggest this rare condition, though the specific features of Rombo syndrome are not all mentioned in the scenario.