What is the diagnosis of a solitary, round, red, flaky, well-defined lesion, 1 centimeter (cm) in diameter, located on the forehead, with normal surrounding skin, present for approximately 3 weeks in a 30-year-old woman?

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Differential Diagnosis for a Single Round Red Flaky Lesion on the Forehead

Single Most Likely Diagnosis

  • Seborrheic Keratosis: A common, benign skin growth that can appear as a round, red, flaky lesion, especially on the face. Its well-defined borders and the fact that it's isolated make this a strong consideration.

Other Likely Diagnoses

  • Actinic Keratosis: A precursor to skin cancer that can present as a red, flaky patch, often due to sun exposure. Although the forehead is a common location, the lack of mention of sun exposure or other risk factors makes it slightly less likely.
  • Eczema/Dermatitis: Could present with redness and flakiness, but typically would be more diffuse or have a history of similar episodes.
  • Psoriasis: Can cause well-defined red, scaly patches, but usually involves other areas of the body and has a more chronic course.

Do Not Miss Diagnoses

  • Basal Cell Carcinoma: The most common form of skin cancer, which can present as a solitary, well-defined lesion. Early detection is crucial, making it a "do not miss" diagnosis despite its lower likelihood based on the short duration and appearance.
  • Squamous Cell Carcinoma: Another form of skin cancer that can appear as a red, scaly lesion. It's less common than basal cell carcinoma but more aggressive, necessitating its consideration.

Rare Diagnoses

  • Discoid Lupus Erythematosus: An autoimmune condition that can cause disk-shaped lesions, often on the face, which can be red and scaly. It's less common and usually associated with other systemic or dermatological symptoms.
  • Granuloma Faciale: A rare condition characterized by single or multiple, well-defined, red to purple plaques on the face, which could potentially present similarly but is much less common.
  • Cutaneous T-Cell Lymphoma (Mycosis Fungoides): A rare form of skin cancer that can present with a variety of skin lesions, including patches, plaques, or tumors. It's an unlikely diagnosis for a single, well-defined lesion but should be considered in the differential due to its potential severity.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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