Differential Diagnosis for Subcutaneous Nodules to Extremities and Trunk
Single Most Likely Diagnosis
- Rheumatoid Arthritis (RA): Subcutaneous nodules are a common extra-articular manifestation of RA, often found on the extremities and trunk. They are usually associated with more severe disease and can be a sign of active inflammation.
Other Likely Diagnoses
- Gout: Tophi, which are deposits of monosodium urate crystals, can form subcutaneous nodules, typically on the extremities, in patients with chronic gout.
- Sarcoidosis: This systemic granulomatous disease can cause subcutaneous nodules as part of its skin manifestations, which can appear on the trunk and extremities.
- Lipoma: Benign tumors composed of fat tissue, lipomas can present as subcutaneous nodules anywhere on the body, including the extremities and trunk.
Do Not Miss Diagnoses
- Neurofibromatosis Type 1 (NF1): While less common, NF1 can present with subcutaneous neurofibromas, which are a type of tumor that arises from nerve tissue. Missing this diagnosis could have significant implications for the patient and their family due to the genetic nature of the disease.
- Subcutaneous Panniculitis-like T-cell Lymphoma (SPTCL): A rare and aggressive form of lymphoma that presents with subcutaneous nodules, often on the legs. Early diagnosis is crucial for treatment and prognosis.
Rare Diagnoses
- Erythema Induratum (Bazin Disease): A rare form of panniculitis that presents with recurrent subcutaneous nodules, typically on the calves of young women. It is often associated with tuberculosis.
- Nodular Vasculitis: Also known as erythema induratum, this condition involves inflammation of the blood vessels and can present with subcutaneous nodules, usually on the lower legs.
- Subcutaneous Granuloma Annulare: A benign condition characterized by the formation of granulomas in the subcutaneous tissue, presenting as nodules, often on the extremities or trunk.