Differential Diagnosis for a Cauliflower-like Skin Lesion

• Single most likely diagnosis
  • Seborrheic keratosis: This is a common, benign skin growth that can appear as a cauliflower-like lesion, especially in older adults. It's often pigmented and has a waxy or stuck-on appearance.
• Other Likely diagnoses
  • Verruca vulgaris (common wart): Caused by the human papillomavirus (HPV), these warts can appear as cauliflower-like lesions, particularly on the hands or feet.
  • Keratoacanthoma: A low-grade, or sometimes considered benign, tumor of the skin that can resemble a cauliflower in its appearance, often growing rapidly before potentially regressing.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Squamous cell carcinoma: Although less common than other skin cancers, this type can sometimes present with a cauliflower-like appearance, especially in sun-exposed areas. Early detection is crucial for effective treatment.
  • Basal cell carcinoma: The most common form of skin cancer, which can occasionally appear as a cauliflower-like lesion, particularly the pigmented variant.
• Rare diagnoses
  • Epidermodysplasia verruciformis: A rare skin disorder associated with a high risk of skin cancer, characterized by an abnormal susceptibility to HPV infections, leading to multiple types of skin lesions, including those resembling cauliflower.
  • Malignant melanoma (rarely): While most melanomas have distinct characteristics (e.g., ABCDE criteria), some rare variants might initially resemble a cauliflower-like lesion, making thorough examination and biopsy crucial for diagnosis.