Differential Diagnosis
- Single Most Likely Diagnosis + Benign melanocytic nevus with reactive lymphaden descriptor: The patient's long-standing belly button mole with recent changes and peeling, but no itching or bleeding, suggests a benign melanocytic nevus. The presence of palpable, non-tender, and movable lymph nodes in the neck and elbows, along with night sweats, could be indicative of a reactive lymphaden descriptor, which is a non-specific response to various stimuli, including infections, autoimmune disorders, or other benign conditions.
- Other Likely Diagnoses + Atopic dermatitis or eczema: The patient's description of dark spots that peel off, along with the presence of night sweats, could be related to atopic dermatitis or eczema, which are common skin conditions that can cause skin lesions and systemic symptoms. + Viral or bacterial infections: The patient's symptoms, including night sweats and palpable lymph nodes, could be indicative of a viral or bacterial infection, such as mononucleosis or tuberculosis, although these would typically be accompanied by other symptoms like fever, fatigue, or weight loss. + Autoimmune disorders: The patient's symptoms, including palpable lymph nodes and night sweats, could be related to an autoimmune disorder, such as lupus or rheumatoid arthritis, although these would typically be accompanied by other symptoms like joint pain, fever, or skin rashes.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed) + Malignant melanoma: Although the patient's mole has been present for over 13 years, it is essential to rule out malignant melanoma, as it can be deadly if left untreated. A biopsy of the mole would be necessary to confirm the diagnosis. + Lymphoma: The patient's palpable lymph nodes, night sweats, and weight loss (if present) could be indicative of lymphoma, a type of blood cancer that requires prompt diagnosis and treatment. + Tuberculosis: Although less likely, tuberculosis (TB) can cause palpable lymph nodes, night sweats, and weight loss, and can be deadly if left untreated. A TB test and further evaluation would be necessary to rule out this diagnosis.
- Rare Diagnoses + Mycosis fungoides: A rare type of cutaneous T-cell lymphoma that can cause skin lesions and systemic symptoms, including night sweats and palpable lymph nodes. + Leopard syndrome: A rare genetic disorder that can cause multiple melanocytic nevi, along with other systemic symptoms, including cardiac and neurological abnormalities.