Differential Diagnosis for Oral/Genital Ulcerations
Single Most Likely Diagnosis
- Recurrent Aphthous Stomatitis (Canker Sores): This is a common condition characterized by recurrent, painful ulcers in the oral cavity, often triggered by stress, trauma, or certain foods. The genital area can also be affected, although this is less common. The condition is usually self-limiting and resolves on its own.
Other Likely Diagnoses
- Herpes Simplex Virus (HSV) Infection: HSV can cause painful ulcers in both the oral and genital areas. The primary infection often presents with multiple, painful vesicles that rupture to form ulcers. Recurrent episodes are usually less severe.
- Syphilis: The primary stage of syphilis is characterized by a painless chancre, usually on the genitals, but can also occur in the oral cavity. If left untreated, syphilis can progress to secondary and tertiary stages with more severe symptoms.
- Behçet's Disease: A form of vasculitis that can cause recurrent oral and genital ulcers, along with other symptoms like uveitis and skin lesions. The disease is more common in certain parts of the world, like the Middle East and Asia.
Do Not Miss Diagnoses
- Cancer (Squamous Cell Carcinoma): Although less common, ulcers in the oral or genital area can be a sign of underlying cancer. It's crucial to investigate any non-healing ulcers, especially in individuals with risk factors like smoking or HPV infection.
- Lymphogranuloma Venereum (LGV): A sexually transmitted infection caused by certain strains of Chlamydia trachomatis, which can cause genital ulcers, lymphadenopathy, and other systemic symptoms. If not treated promptly, LGV can lead to serious complications.
- HIV Infection: Oral and genital ulcers can be an early sign of HIV infection. It's essential to consider HIV testing in individuals with risk factors or other symptoms suggestive of immunocompromise.
Rare Diagnoses
- Erythema Multiforme: An immune-mediated condition characterized by target-like lesions and ulcers in the oral and genital mucosa, often triggered by infections or medications.
- Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: Severe skin and mucous membrane disorders, usually drug-induced, which can cause widespread ulcers and skin detachment.
- Granuloma Inguinale (Donovanosis): A rare sexually transmitted infection caused by Klebsiella granulomatis, characterized by genital ulcers that are usually painless and bleed easily.