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B cell lymphoma

Primary cutaneous B-cell lymphoma originates in the skin, whereas a metastasis is from an internal primary cancer; they can be clinically identical and are distinguished by staging.

Keratoacanthoma

A KA is a rapidly growing, crater-like nodule with a central keratin plug, a specific morphology not typical for a metastatic nodule.

Pyogenic granuloma

A PG is a benign, friable, vascular tumor that bleeds easily, unlike the typically firm, non-friable nature of a skin metastasis.

Squamous cell carcinoma

A primary cutaneous SCC arises on sun-exposed skin, often from a precursor AK, whereas a metastatic SCC comes from another site (e.g., lung, oral cavity).

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