Differential Diagnosis for Abdominal Wound and Scarring
- Single most likely diagnosis:
- Acne vulgaris with post-inflammatory hyperpigmentation (PIH) and scarring: This is the most likely diagnosis given the history of pimples rupturing and causing scarring, which is a common complication of acne, especially in areas with higher skin tension like the abdomen.
- Other Likely diagnoses:
- Keloid or hypertrophic scarring: These conditions are characterized by raised, thick scars that can occur after skin injuries, including acne. The dark brown/purple color could be due to the scarring process.
- Folliculitis: This is an inflammatory condition affecting the hair follicles, which could lead to scarring and pigmentation changes if severe or recurrent.
- Hidradenitis suppurativa: Although less common on the abdomen, this condition involves recurrent, painful abscesses and nodules that can lead to scarring.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Squamous cell carcinoma or basal cell carcinoma: Although rare, skin cancers can present as non-healing wounds or scars. A biopsy would be necessary to rule out malignancy, especially if there's a history of sun exposure or other risk factors.
- Pyoderma gangrenosum: A rare skin condition that can start as a pimple-like lesion and progress to a painful ulcer, which could be mistaken for a wound or scar.
- Rare diagnoses:
- Sarcoidosis: This systemic disease can cause skin lesions, including those that resemble acne or scars, but it's much less common and would typically be accompanied by other systemic symptoms.
- Dermatosis papulosa nigra: A condition characterized by multiple, small, dark bumps on the skin, which could potentially be mistaken for scarring or hyperpigmentation, though it doesn't typically present with a history of ruptured pimples.