Differential Diagnosis
- Single most likely diagnosis:
- Benign nevus or seborrheic keratosis: The mole has been present for over 13 years and was previously assessed as benign by a dermatologist. The recent changes may be due to natural evolution or irritation. The presence of moveable and non-hard lymph nodes, as well as the lack of systemic symptoms such as fever or weight loss, also suggests a benign condition.
- Other Likely diagnoses:
- Lipoma or other benign soft tissue tumor: The fullness under the left ribs could be due to a benign tumor, which may also explain the shoulder inflammation.
- Reactive lymphadenopathy: The palpable lymph nodes in the neck and elbow could be a reaction to a minor infection or inflammation, such as the ingrown hair.
- Costochondritis: The fullness under the left ribs and shoulder inflammation could be due to costochondritis, an inflammatory condition of the cartilage that connects the ribs to the breastbone.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Melanoma with metastasis: Although the mole was previously assessed as benign, the recent changes and the presence of lymph nodes warrant further investigation to rule out melanoma.
- Lymphoma: The presence of lymph nodes in multiple areas, although moveable and non-hard, requires consideration of lymphoma, a type of blood cancer.
- Metastatic cancer: The fullness under the left ribs could be due to a metastatic tumor, which would require prompt investigation and treatment.
- Rare diagnoses:
- Dermatofibrosarcoma protuberans: A rare type of skin cancer that can present as a mole or nodule.
- Angiosarcoma: A rare and aggressive type of cancer that can present as a mole or lesion.
- Kaposi's sarcoma: A rare type of cancer that can present as a mole or lesion, often associated with immune suppression.