What is the diagnosis for a lesion with induration, erythema, and a small ulceration or sinus tract?

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Differential Diagnosis for Induration with Erythema and Small Hole

  • Single Most Likely Diagnosis
    • Furuncle (boil): A localized infection of the skin and subcutaneous tissue, typically caused by Staphylococcus aureus, which can present with induration, erythema, and a small hole or pustule.
  • Other Likely Diagnoses
    • Carbuncle: Similar to a furuncle but larger and more severe, often with multiple openings or holes, caused by a deeper infection.
    • Abscess: A collection of pus that has built up within the tissue of the body, which can cause induration and erythema, and may have a small hole or fistula.
    • Infected cyst: A skin cyst that has become infected, leading to induration, erythema, and possibly a small hole or pustule.
  • Do Not Miss Diagnoses
    • Necrotizing fasciitis: A severe infection that destroys the tissue under the skin, including fat and the tissue covering the muscles (fascia), which can present with induration, erythema, and possibly small holes or blisters, and is life-threatening if not promptly treated.
    • Gas gangrene: A potentially deadly condition resulting from infection of wounds with bacteria of the genus Clostridium, which can produce gas under the skin, leading to induration, erythema, and small holes or crepitus.
  • Rare Diagnoses
    • Erysipelas: A type of skin infection that affects the upper layer of the skin, typically caused by group A beta-hemolytic streptococci, which can present with well-demarcated erythema and induration but is less likely to have a small hole.
    • Cutaneous leishmaniasis: A tropical disease caused by parasites of the Leishmania type, transmitted by sandflies, which can cause skin lesions with induration, erythema, and possibly small holes or ulcers.
    • Mycobacterial infections (e.g., cutaneous tuberculosis): Rare infections caused by Mycobacteria, which can lead to chronic skin lesions with induration, erythema, and small holes or sinuses.

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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