Differential Diagnosis for Skin Sores on the Upper Nasal Bridge and Above Eyebrow
Single Most Likely Diagnosis
- Basal Cell Carcinoma: This is a common skin cancer that often presents as a sore or lesion on sun-exposed areas, such as the face, including the upper nasal bridge and above the eyebrow. Its slow growth and lack of systemic symptoms like fever make it a likely consideration in this scenario.
Other Likely Diagnoses
- Squamous Cell Carcinoma: Another type of skin cancer that can appear as a sore or scaly patch on sun-exposed areas. It's more aggressive than basal cell carcinoma but still doesn't typically cause fever or lymphadenopathy in early stages.
- Actinic Keratosis: A precursor to squamous cell carcinoma, presenting as small, rough, sandpapery patches on sun-exposed areas. While not immediately dangerous, its potential to progress to squamous cell carcinoma makes it a significant consideration.
- Seborrheic Keratosis: A benign growth that can appear as a sore or wart-like lesion. It's common in older adults and can be found on the face, including the areas mentioned.
- Infected Sebaceous Cyst or Epidermoid Cyst: These can become inflamed and present as a sore, especially if they become infected. However, the absence of fever and lymphadenopathy might make this less likely unless the infection is very localized.
Do Not Miss Diagnoses
- Malignant Melanoma: Although less common than other skin cancers, melanoma is much more dangerous due to its potential for metastasis. Any new or changing skin lesion, especially one that is pigmented, irregular, or changing in size, should be evaluated for melanoma.
- Lymphoma (Cutaneous T-Cell Lymphoma): This can present with skin lesions that might resemble sores or patches. While less common, missing a diagnosis of lymphoma could have severe consequences.
- Infectious Diseases (e.g., Leprosy, Cutaneous Leishmaniasis): Certain infectious diseases can cause skin sores and might not always present with systemic symptoms like fever, especially in early stages or in immunocompromised individuals.
Rare Diagnoses
- Dermatofibroma: A benign skin growth that can appear as a firm, round, brownish to purple growth, often resulting from minor injury, most commonly on the legs but can appear elsewhere.
- Keratoacanthoma: A low-grade, or sometimes considered benign, malignancy that resembles squamous cell carcinoma but has a distinctive appearance and often resolves on its own.
- Metastatic Cancer to the Skin: While rare, cancer from other parts of the body can metastasize to the skin, presenting as a sore or nodule. This would be an unusual presentation for metastasis but should be considered, especially in patients with a known history of cancer.