Differential Diagnosis
- Single most likely diagnosis
- Health anxiety disorder with benign lymphadenopathy: The patient's history of health anxiety and general anxiety, combined with the presence of palpable lymph nodes that have not changed in 9 months, suggests that her symptoms may be exacerbated or perpetuated by her anxiety. The recent appearance of lymph nodes in her left elbow could be related to the scratching of the ingrown hair, leading to a localized reaction.
- Other Likely diagnoses
- Reactive lymphadenopathy: The presence of palpable lymph nodes in the neck and elbow could be a reaction to a viral or bacterial infection, or even a response to the scratching of the ingrown hair.
- Fibromyalgia or stress-related muscle tension: The patient's shoulder pain and tension could be related to her stress and anxiety, leading to muscle tension and pain.
- Benign melanocytic nevus: The belly button mole that has been present for 13 years and was previously deemed benign by a dermatologist is likely a benign growth.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lymphoma: Although the patient's lymph nodes have not changed in 9 months, lymphoma is a potentially life-threatening condition that must be considered, especially if the lymph nodes are persistent or growing.
- Metastatic melanoma: Although the patient's mole was previously deemed benign, any changes in the mole's appearance, such as spreading or darkening, warrant further evaluation to rule out melanoma.
- Infection or abscess: The patient's recent scratching of the ingrown hair could have introduced bacteria into the wound, leading to an infection or abscess.
- Rare diagnoses
- Sarcoidosis: A rare condition characterized by the growth of granulomas in various parts of the body, including the lymph nodes.
- Kikuchi disease: A rare condition characterized by lymphadenopathy, often accompanied by fever and night sweats.
- Dermatofibrosarcoma protuberans: A rare type of skin cancer that can present as a growing mole or nodule.