Differential Diagnosis for Painful Skin Lesion Behind Ear

Single Most Likely Diagnosis

• Furuncle or Abscess: A localized infection of the skin and subcutaneous tissue, often caused by Staphylococcus aureus, which can become painful and may feel better temporarily when squeezed due to the release of pressure.

Other Likely Diagnoses

• Epidermoid Cyst: A benign cyst that can become inflamed and painful, sometimes feeling better when squeezed due to the release of built-up pressure or contents.
• Infected Sebaceous Cyst: Similar to an epidermoid cyst but originates from sebaceous glands, can become infected and painful, improving temporarily with squeezing.
• Folliculitis: An inflammation of the hair follicles, which can be painful and may improve with squeezing, although this is not typically recommended as it can lead to further inflammation or infection.

Do Not Miss Diagnoses

• Mastoiditis: An infection of the mastoid bone located behind the ear, which can present with pain and swelling in the area and is a serious condition requiring prompt medical attention.
• Parotid Gland Abscess: An abscess of the parotid gland, which can cause severe pain and swelling in the area behind the ear and requires urgent medical evaluation.

Rare Diagnoses

• Pilomatrixoma: A rare, benign tumor of the skin that can cause a painful lesion, although it is more common in children and not typically associated with improvement by squeezing.
• Branchial Cleft Cyst: A congenital anomaly that can present as a painful cyst behind the ear, especially if it becomes infected, though it's less likely to feel better with squeezing.