Differential Diagnosis for Tender Lesion on Scalp with Flaking

• Single Most Likely Diagnosis
  • Seborrheic dermatitis: This condition is characterized by a tender, flaky lesion on the scalp, often accompanied by redness and itching. It's a common condition that affects the oily areas of the body, making the scalp a prime location.
• Other Likely Diagnoses
  • Psoriasis: Psoriasis can cause tender, flaky lesions on the scalp, along with redness and scaling. It's an autoimmune condition that speeds up the life cycle of skin cells, leading to a buildup of cells on the surface of the skin.
  • Eczema (atopic dermatitis): Eczema can cause tender, itchy, and flaky lesions on the scalp, especially in individuals with a history of allergies or asthma.
  • Tinea capitis (ringworm of the scalp): This fungal infection can cause tender, flaky lesions on the scalp, along with hair loss and redness.
• Do Not Miss Diagnoses
  • Squamous cell carcinoma: Although rare, squamous cell carcinoma can present as a tender, flaky lesion on the scalp. It's essential to consider this diagnosis, especially in older adults or individuals with a history of skin cancer.
  • Basal cell carcinoma: Similar to squamous cell carcinoma, basal cell carcinoma can present as a tender, flaky lesion on the scalp, and it's crucial to rule out this diagnosis to ensure timely treatment.
• Rare Diagnoses
  • Kerion: A rare complication of tinea capitis, kerion is a severe inflammatory reaction that can cause a tender, flaky lesion on the scalp, along with swelling and pus.
  • Discoid lupus erythematosus: This autoimmune condition can cause tender, flaky lesions on the scalp, along with scarring and hair loss.
  • Lichen planus: A rare condition that can cause tender, flaky lesions on the scalp, along with itching and redness.