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Basal cell carcinoma

A nodular or ulcerative skin cancer with a pearly border and telangiectasias, which lacks the rubbery texture and granulomatous inflammation of a gumma.

Deep fungal infection

Can cause ulcerative nodules, but is diagnosed by fungal culture or special stains on a biopsy specimen.

Lupus vulgaris

Cutaneous tuberculosis that presents as reddish-brown nodules showing an 'apple-jelly' color on diascopy, and biopsy reveals caseating granulomas.

Pyogenic granuloma

A friable, bright red vascular papule that bleeds easily, unlike the firm, indurated, and often ulcerative gumma.

Squamous cell carcinoma

A firm, indurated nodule or ulcer, but biopsy will show malignant keratinocytes, not the granulomatous inflammation and endarteritis of a gumma.

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