Differential Diagnosis for Small Bumps on the Top of the Foot
Single Most Likely Diagnosis
- Verruca (Plantar Wart): The description of small bumps that are painful, can be scraped off and popped, but return, is highly suggestive of verruca. The shooting pains are also consistent with the diagnosis, as pressure on the wart can cause sharp pain.
Other Likely Diagnoses
- Keratosis Pilaris: This condition causes small, rough bumps on the skin, often on the feet, and can be associated with discomfort or pain, especially if the bumps become inflamed.
- Seborrheic Keratosis: These are benign growths that can appear as small bumps and can sometimes be itchy or painful, although they are less likely to cause shooting pains.
- Folliculitis: An inflammation of the hair follicles, which can cause small, painful bumps, especially if infected. However, the ability to scrape them off and pop them is less typical.
Do Not Miss Diagnoses
- Squamous Cell Carcinoma: Although less likely, any persistent or recurring skin lesion, especially one that is painful or changes in appearance, should be evaluated for the possibility of skin cancer. Early detection is crucial for effective treatment.
- Malignant Melanoma: Similarly, any new or changing skin lesion should be considered for melanoma, given its potential severity and the importance of early intervention.
Rare Diagnoses
- Eccrine Poroma: A rare, benign tumor of the sweat glands that can present as a painful nodule or bump, often on the foot.
- Glomus Tumor: A rare, benign tumor of the glomus body that can cause severe, sharp pain, often localized to a small area, such as the foot. These tumors are typically found under the nail but can occur elsewhere on the foot.
- Neurofibroma: A benign nerve sheath tumor that can cause pain and can present as a small bump, although it's less common on the top of the foot and not typically described as something that can be scraped off and popped.