Differential Diagnosis for Scrotal Ulcer
- Single most likely diagnosis
- Chronic cutaneous leishmaniasis: This condition is characterized by a chronic, painful ulcer with a white discharge, which matches the patient's symptoms. The duration of approximately 5 years also supports this diagnosis.
- Other Likely diagnoses
- Cutaneous squamous cell carcinoma: This type of skin cancer can present as a chronic, painful ulcer, especially in areas exposed to the sun or with a history of trauma. The cracking and white discharge could be indicative of a malignant process.
- Granuloma inguinale (Donovanosis): This is a sexually transmitted infection that can cause chronic, painful ulcers with a white or yellowish discharge. The location on the scrotum and the duration of symptoms make this a possible diagnosis.
- Eczema or contact dermatitis: Chronic skin conditions like eczema or contact dermatitis can cause painful, cracked skin with a white discharge, especially if infected.
- Do Not Miss diagnoses
- Testicular cancer with cutaneous metastasis: Although rare, testicular cancer can metastasize to the skin, causing ulcers or lesions. Given the location on the scrotum, it's essential to rule out testicular cancer.
- Syphilis (tertiary stage): Tertiary syphilis can cause gummas, which are painful, ulcerative lesions that can appear on the skin, including the scrotum.
- Rare diagnoses
- Blastomycosis: This is a fungal infection that can cause skin lesions, including ulcers, but it's relatively rare and usually associated with systemic symptoms.
- Chromoblastomycosis: This is another fungal infection that can cause chronic, painful skin lesions, but it's rare and typically found in tropical regions.
- Lymphogranuloma venereum (LGV): This is a sexually transmitted infection that can cause ulcers, but it's relatively rare and usually accompanied by other symptoms like lymphadenopathy.