A 6-year-old boy presents with a 3-month history of an asymptomatic, slowly enlarging, flesh-colored nodule on the left cheek. The lesion has a central keratin-filled crater and a rolled border. It bleeds minimally with trauma. What is the most likely diagnosis?

• A Wart (verruca vulgaris)
• B Pyogenic granuloma
• C Basal cell carcinoma
• D Keratoacanthoma ✓

Explanation

Keratoacanthoma presents as a rapidly growing, dome-shaped nodule with a central keratin crater, often on sun-exposed skin. Though more common in adults, it can occur in children, particularly in familial syndromes. Pyogenic granuloma is a vascular, easily bleeding papule without a keratin crater. Basal cell carcinoma is rare in children and presents as a pearly papule with telangiectasia. Verruca vulgaris is a rough, hyperkeratotic papule without a central crater.

Reference: Andrews' Diseases of the Skin: Clinical Dermatology, 13th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.