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Last updated: August 1, 2025View editorial policy

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Differential Diagnosis for Nodules on Shin

  • Single most likely diagnosis
    • Erythema nodosum: This is the most common cause of nodules on the shin, characterized by tender, erythematous nodules, often associated with an underlying infection, inflammatory condition, or medication.
  • Other Likely diagnoses
    • Erythema induratum: A type of panniculitis that presents with tender, nodular lesions on the lower legs, often associated with tuberculosis or other infections.
    • Necrobiosis lipoidica: A condition characterized by necrotic, granulomatous lesions on the shins, often associated with diabetes.
    • Granuloma annulare: A benign condition that presents with papular or nodular lesions on the skin, often on the hands and feet, but can also occur on the shins.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Subcutaneous panniculitis-like T-cell lymphoma: A rare and aggressive form of lymphoma that can present with subcutaneous nodules, including on the shins.
    • Sarcoidosis: A systemic granulomatous disease that can present with skin nodules, including on the shins, and can be associated with serious internal organ involvement.
    • Deep vein thrombosis: Although not typically presenting as a nodule, DVT can cause swelling and tenderness in the leg, which may be mistaken for a nodule.
  • Rare diagnoses
    • Rheumatoid nodules: Although more common on the hands and feet, rheumatoid nodules can occur on the shins in patients with rheumatoid arthritis.
    • Xanthomas: Benign growths composed of lipid-laden macrophages, which can occur on the shins, often associated with hyperlipidemia.
    • Lipodermatosclerosis: A condition characterized by induration and pigmentation of the skin on the lower legs, often associated with chronic venous insufficiency.

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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