Differential Diagnosis for Erosions in the Concha of a 15-Year-Old Male
Single Most Likely Diagnosis
- Darier's disease: A genetic disorder that affects the skin, leading to the formation of keratotic papules and erosions, particularly in the ears. The long-standing nature of the symptoms and the specific location in the concha make this a plausible diagnosis.
Other Likely Diagnoses
- Seborrheic keratosis: Benign growths that can appear as erosions or lesions, often in older adults but can occur in younger individuals. Their presence in the concha, although less common, could explain the symptoms.
- Actinic keratosis: A condition caused by prolonged sun exposure, leading to the formation of small, rough, sandpaper-like lesions that can sometimes appear as erosions. The bilateral nature and location in sun-exposed areas like the ears support this possibility.
- Discoid lupus erythematosus: An autoimmune condition that can cause skin lesions, including erosions, particularly in sun-exposed areas. The chronic nature of the condition and its potential to cause lesions in the ears make it a consideration.
Do Not Miss Diagnoses
- Squamous cell carcinoma: Although rare in a 15-year-old, any persistent or changing lesion, especially in sun-exposed areas, warrants consideration of skin cancer due to its potential severity and the importance of early detection.
- Basal cell carcinoma: The most common form of skin cancer, which can present as non-healing erosions. Given the location and the potential for sun exposure, it's crucial not to miss this diagnosis.
Rare Diagnoses
- Keratosis obturans: A rare condition characterized by the accumulation of desquamated keratin material within the ear canal, potentially causing erosion. It's less likely but could be considered given the specific location.
- Relapsing polychondritis: An autoimmune disorder that can cause cartilage inflammation, potentially affecting the ears and leading to erosions. The bilateral and chronic nature of the symptoms might suggest this rare condition.