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Actinic keratosis

An AK is a precancerous lesion distinguished by its rough, sandpaper-like texture, whereas a BCC is typically smoother with a pearly quality.

Chondrodermatitis nodularis helicis

This is an exquisitely painful papule located specifically on the ear cartilage, with tenderness being a much more prominent feature than in a typical BCC.

Dermatofibroma

The key differentiator is the "dimple sign": a dermatofibroma retracts with lateral pressure, while a nodular BCC does not.

Intradermal naevus

This benign mole is typically soft, flesh-colored, and lacks the pearly border, ulceration, or telangiectasias seen in a nodular BCC.

Seborrhoiec keratosis

This benign growth has a characteristic "stuck-on," waxy or crumbly appearance, unlike the pearly, translucent quality of a BCC.

Squamous cell carcinoma

SCC is typically a firmer, more indurated, and scaly or ulcerated tumor, lacking the classic pearly border and surface telangiectasias of a BCC.

Viral wart

A wart often has a verrucous (cauliflower-like) surface and may have visible thrombosed capillaries (black dots), features not seen in a BCC.

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