Differential Diagnosis for a Hard Lesion on the Peri-Rectal Area
Single Most Likely Diagnosis
- Perianal abscess or cyst: This is a common condition that presents as a hard, painful lesion in the peri-anal area. The mild erythema and hard subcentimeter lesion under the skin are consistent with an abscess or cyst.
Other Likely Diagnoses
- Pilonidal sinus: A pilonidal sinus can present as a hard, painful nodule in the peri-anal area, often with mild erythema. It is a common condition, especially in young adults.
- Fistula-in-ano: A fistula-in-ano can present as a hard, painful lesion in the peri-anal area, often with mild erythema. It is a common condition that can be associated with abscesses or other anorectal diseases.
- Hidradenitis suppurativa: This is a chronic skin condition that can present as a hard, painful nodule in the peri-anal area, often with mild erythema. It is more common in women and can be associated with other skin lesions.
Do Not Miss Diagnoses
- Anal cancer: Although rare, anal cancer can present as a hard, painless lesion in the peri-anal area. It is essential to consider this diagnosis, especially in older adults or those with a history of human papillomavirus (HPV) infection.
- Rectal carcinoma: A rectal carcinoma can present as a hard, painful lesion in the peri-anal area, especially if it has extended to the anal canal. It is essential to consider this diagnosis, especially in older adults or those with a family history of colorectal cancer.
Rare Diagnoses
- Chordoma: A chordoma is a rare, slow-growing tumor that can occur in the peri-anal area. It can present as a hard, painless lesion and is often associated with other symptoms such as constipation or urinary retention.
- Soft tissue sarcoma: A soft tissue sarcoma is a rare, malignant tumor that can occur in the peri-anal area. It can present as a hard, painful lesion and is often associated with other symptoms such as weight loss or fatigue.