Differential Diagnosis for Lesions Resembling Pimples with White Heads on Buttocks Near Lower Area of Vulva

• Single Most Likely Diagnosis
  • Folliculitis: This condition, an inflammation of the hair follicles, is common in areas with high hair density like the buttocks and can present with pustules or white-headed lesions, especially if caused by bacterial infection.
• Other Likely Diagnoses
  • Furuncles or Carbuncles: These are infections of the hair follicle that can extend into the deeper tissue, often caused by Staphylococcus aureus. They can appear as painful, swollen bumps that may have a white head.
  • Keratosis Pilaris: Although more common on the arms and legs, this condition can occasionally appear on the buttocks, presenting as small, rough bumps that might resemble white-headed pimples.
  • Hidradenitis Suppurativa: A chronic skin condition characterized by recurring, painful abscesses and nodules in areas of the body with apocrine sweat glands, such as the groin and buttocks. Early lesions might resemble pimples.
• Do Not Miss Diagnoses
  • Herpes Simplex Virus (HSV) Infection: Although typically presenting with vesicles or ulcers, in some cases, especially during the initial outbreak, lesions might resemble pimples. Given the potential for significant morbidity and the importance of antiviral treatment, this diagnosis should not be overlooked.
  • Syphilis (Secondary): This stage of syphilis can manifest with a wide range of skin lesions, including those that might resemble pimples or folliculitis. The diagnosis is critical due to the need for antibiotic treatment to prevent long-term complications.
• Rare Diagnoses
  • Pilar Cysts: Also known as trichilemmal cysts, these are benign cysts originating from the hair follicle. While they can appear on the scalp, they are less commonly found on the buttocks and might present as firm, mobile masses that could be mistaken for large pimples.
  • Steatocystoma Multiplex: A rare condition characterized by multiple, benign cysts that can appear on the body, including the buttocks. These cysts might resemble large pimples but are usually filled with a cheesy material.