Differential Diagnosis for a 91-year-old Male with Thickened Rough Scrotum
- Single most likely diagnosis
- Lichen sclerosus: This condition is characterized by thinning and whitening of the skin, often accompanied by itching and pain. It can lead to scarring and thickening of the skin if left untreated, which fits the description of a thickened rough scrotum.
- Other Likely diagnoses
- Eczema/Dermatitis: Chronic eczema or dermatitis can cause thickening and roughening of the skin due to repeated scratching and inflammation.
- Psoriasis: This autoimmune condition can cause thick, scaly patches on the skin, including the scrotum, leading to a rough texture.
- Seborrheic keratosis: These benign growths can appear as rough, thickened patches on the skin, including the scrotum.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Squamous cell carcinoma: Although less common, skin cancers like squamous cell carcinoma can present as thickened, rough skin lesions and must be ruled out due to their potential for malignancy.
- Extramammary Paget's disease: A rare skin cancer that can appear as a thickened, red, scaly patch on the scrotum, requiring prompt diagnosis and treatment.
- Rare diagnoses
- Scleroderma: A chronic autoimmune disease that can cause thickening and hardening of the skin, potentially affecting the scrotum.
- Mycosis fungoides: A rare type of cutaneous T-cell lymphoma that can cause skin lesions, including on the scrotum, which may appear as thickened and rough.