Differential Diagnosis for a Small, Round, Boggy Lesion at the Back of the Heel

• Single Most Likely Diagnosis
  • Cyst (e.g., sebaceous cyst, epidermoid cyst): These are common, benign lesions that can appear as small, round, and sometimes boggy masses. Their location at the back of the heel, away from pressure areas, and the absence of symptoms like pain or itching, make a cyst a plausible diagnosis.
• Other Likely Diagnoses
  • Lipoma: A benign tumor of fat cells, lipomas can feel soft and boggy. They are common in subcutaneous tissues and can occur almost anywhere on the body, including the back of the heel.
  • Dermatofibroma: Although typically found on the legs, these benign growths can appear as firm to soft, round lesions. They might not perfectly match the "boggy" description but are worth considering due to their variability in appearance.
  • Abscess or Furuncle (early stage): An abscess or furuncle (boil) could present as a boggy lesion, especially if it's not yet fully developed or if it's partially drained. However, these are usually painful and may have surrounding erythema, which doesn't match this case perfectly.
• Do Not Miss Diagnoses
  • Soft Tissue Sarcoma: Although rare, sarcomas can present as painless, growing masses. It's crucial to consider malignant possibilities, even if they are less likely, due to their significant implications for treatment and prognosis.
  • Infectious Lesions (e.g., Mycobacterial infections, fungal infections): Certain infections can cause lesions that might appear boggy or cystic. These could be serious and require specific treatments, making them important not to miss.
• Rare Diagnoses
  • Neurofibroma: A type of nerve sheath tumor, neurofibromas can be soft and may appear as boggy lesions, though they are more commonly associated with neurofibromatosis type 1.
  • Glomus Tumor: Typically found under the nail, glomus tumors can occasionally appear in other locations, including the skin of the heel. They are usually painful, especially to pressure, which doesn't fit this case well, but their rarity and potential for being overlooked warrant mention.
  • Hidradenoma Papilliferum or other sweat gland tumors: These are rare, benign tumors of the sweat glands that could potentially present as small, round lesions, though they are not commonly described as boggy.