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Last updated: July 15, 2025View editorial policy

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Differential Diagnosis for Nodules on Legs

Single Most Likely Diagnosis

  • Erythema nodosum: This is a common condition characterized by the sudden onset of tender, erythematous nodules on the lower extremities, often associated with an underlying infection, inflammatory disease, or drug reaction.

Other Likely Diagnoses

  • Cellulitis: An infection of the skin and subcutaneous tissue, which can present with nodular lesions, especially if there is an abscess formation.
  • Folliculitis: Inflammation of the hair follicles, which can cause nodular lesions on the legs, particularly in areas prone to shaving or friction.
  • Keratosis pilaris: A benign condition characterized by small, rough, sandpaper-like nodules on the skin, often on the legs, due to excess keratin.

Do Not Miss Diagnoses

  • Deep Vein Thrombosis (DVT): Although DVT typically presents with swelling, warmth, and discoloration of the leg, it can occasionally cause nodular lesions if there is associated thrombophlebitis or venous ulceration.
  • Malignancy (e.g., lymphoma, metastatic disease): Rarely, nodules on the legs can be a manifestation of an underlying malignancy, making it crucial to investigate further if other symptoms or risk factors are present.
  • Infectious diseases (e.g., tuberculosis, leprosy): Certain infectious diseases can cause nodular skin lesions on the legs, and missing these diagnoses could have significant consequences.

Rare Diagnoses

  • Panniculitis: Inflammation of the subcutaneous fat, which can cause nodular lesions on the legs, often associated with systemic diseases or drug reactions.
  • Necrobiosis lipoidica: A rare condition characterized by necrotic, granulomatous lesions in the skin, often on the lower legs, associated with diabetes mellitus.
  • Sarcoidosis: A systemic granulomatous disease that can cause skin nodules, including on the legs, although this is less common.

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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