Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: September 2, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Nasal Canthus Lesion

The patient's presentation of a bleeding lesion in the nasal canthus with a hard crust that forms and is picked off suggests several potential diagnoses. These can be categorized based on likelihood and the urgency of diagnosis.

  • Single Most Likely Diagnosis

    • Basal Cell Carcinoma (BCC): This is the most common type of skin cancer and can present as a bleeding lesion, especially when it ulcerates and forms a crust. The location in the nasal canthus, an area exposed to the sun, increases the likelihood of BCC.

  • Other Likely Diagnoses

    • Squamous Cell Carcinoma (SCC): Another form of skin cancer that can present similarly to BCC, with ulceration and bleeding. It's less common than BCC but more aggressive.
    • Actinic Keratosis: A precursor to SCC, it can appear as a rough, scaly patch that may bleed and form a crust. It's common in sun-exposed areas.
    • Pyogenic Granuloma: A benign vascular lesion that can bleed easily and form a crust. It often appears as a rapidly growing, bleeding bump.

  • Do Not Miss Diagnoses

    • Melanoma: Although less common than BCC or SCC, melanoma is much more dangerous due to its potential for metastasis. Any pigmented lesion, especially one that bleeds or changes, should be considered for biopsy to rule out melanoma.
    • Merkel Cell Carcinoma: A rare but highly aggressive skin cancer that can present as a firm, painless nodule and may bleed. It's crucial to diagnose early due to its high metastatic potential.

  • Rare Diagnoses

    • Kaposi's Sarcoma: A rare cancer that can appear as lesions on the skin, often in immunocompromised patients. It might present with bleeding and crusting.
    • Dermatofibroma: A benign skin growth that can appear after minor injury, sometimes bleeding if irritated. It's less likely given the description of a hard crust forming and being picked off.
    • Sebaceous Carcinoma: A rare, aggressive cancer of the oil glands, more common in the eyelid area. It can mimic benign conditions but is critical to diagnose early due to its potential for metastasis.

Related Questions

What are alternative medications for bacterial vaginosis (BV)?
Do you need to stop Farxiga (dapagliflozin) before surgery?
What antipsychotic (atypical or typical) is best for a 20-year-old man with acute bipolar depression who wants to minimize weight gain risk?
What is the best course of action for a patient with bipolar disorder and thrombocytopenia (low platelet count) who is taking valproic acid (valproate)?
What is the best approach for a patient with bipolar disorder who has missed 1 day of lamotrigine (lamotrigine) 200 mg daily due to a missed dose?
What is the best treatment option for a 24-year-old pregnant woman at 9 weeks gestation with acute bipolar mania to minimize harm to the fetus?

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question