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Last updated: June 25, 2025View editorial policy

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Differential Diagnosis for a Lump on the Scalp

Single Most Likely Diagnosis

  • Sebaceous cyst: A common, benign lump that forms due to a blocked oil gland in the skin. It is often movable, firm, and may become inflamed or infected.

Other Likely Diagnoses

  • Epidermoid cyst: Similar to a sebaceous cyst but typically filled with a cheesy material and may have a central punctum.
  • Lipoma: A benign tumor composed of fat tissue, which can occur on the scalp and is usually soft and movable.
  • Folliculitis or furuncle: An inflammation of the hair follicle, which can present as a lump and may be tender or infected.
  • Keloid or hypertrophic scar: A raised, thickened area of skin that can occur after injury or surgery, more common in individuals prone to keloid formation.

Do Not Miss Diagnoses

  • Malignant tumor (e.g., squamous cell carcinoma, basal cell carcinoma, melanoma): Although less common, these can present as a lump on the scalp and are critical to diagnose early due to their potential for metastasis and high mortality if left untreated.
  • Metastatic lesion: A lump on the scalp could be a metastasis from a cancer elsewhere in the body, which would significantly alter management and prognosis.
  • Infectious processes (e.g., abscess, osteomyelitis): Especially in immunocompromised patients, these can present as a lump and require urgent treatment to prevent serious complications.

Rare Diagnoses

  • Dermatofibroma: A benign growth that can appear as a firm lump, often following minor injury, and is more common in women.
  • Cylindroma: A rare, benign tumor that can occur on the scalp, often multiple, and can be associated with genetic syndromes.
  • Trichoepithelioma: A rare, benign tumor of hair follicle origin, which can present as a lump on the scalp.
  • Langerhans cell histiocytosis: A rare disorder in which the body accumulates too many immature Langerhans cells, leading to lesions that can appear on the scalp among other places.

Professional Medical Disclaimer

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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