What is the differential diagnosis for a tender erythematous (red) skin lesion?

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Last updated: April 14, 2025View editorial policy

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Differential Diagnosis for Tender Erythematous Skin Lesion

  • Single Most Likely Diagnosis
    • Cellulitis: This is a common condition characterized by a tender, erythematous, and warm skin lesion, often caused by bacterial infection. It's a likely diagnosis due to its prevalence and the match with the symptoms described.
  • Other Likely Diagnoses
    • Abscess: A localized collection of pus that can cause a tender, erythematous lesion. It's a plausible diagnosis given the symptoms, especially if there's a history of trauma or infection.
    • Folliculitis: An inflammation of the hair follicles, which can present as tender, erythematous papules or pustules. This condition is common and could fit the description provided.
    • Contact Dermatitis: A type of skin inflammation caused by contact with irritants or allergens, leading to erythematous and sometimes tender lesions. This is a possible diagnosis, especially if the patient has been exposed to new substances.
  • Do Not Miss Diagnoses
    • Necrotizing Fasciitis: A severe infection that destroys the tissue under the skin, including fat and the tissue covering the muscles (fascia). It's critical to consider this diagnosis due to its high mortality rate if not promptly treated.
    • Erysipelas: A type of skin infection that involves the upper dermis, typically caused by beta-hemolytic group A Streptococcus. It's important not to miss this diagnosis because it can lead to serious complications if not adequately treated.
    • Deep Vein Thrombosis (DVT): While not primarily a skin condition, DVT can cause erythema and tenderness in the affected limb. Missing this diagnosis can have severe consequences, including pulmonary embolism.
  • Rare Diagnoses
    • Erythema Migrans (Lyme Disease): The characteristic rash of Lyme disease, which can appear as a tender, erythematous lesion. It's less common but should be considered, especially in endemic areas or with a history of tick exposure.
    • Sweet Syndrome (Acute Febrile Neutrophilic Dermatosis): A rare condition characterized by fever, neutrophilia, and tender, erythematous skin lesions. It's an important consideration in the differential diagnosis due to its unique presentation and potential systemic implications.

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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