Differential Diagnosis for Scrotal Skin Lesion
Single Most Likely Diagnosis
- Fordyce spots: These are small, smooth, flesh-colored papules that can appear on the scrotum, penis, or lips. They are benign and common, especially in young adults. The patient's description of a cluster of smooth, flesh-colored papules on the scrotum, with no history of sexual activity, makes this a likely diagnosis.
Other Likely Diagnoses
- Angiokeratomas: These are small, dark red to purple lesions that can appear on the scrotum. However, they can also be flesh-colored. They are usually asymptomatic and can be found in clusters.
- Seborrheic keratoses: These are benign growths that can appear anywhere on the body, including the scrotum. They are usually flesh-colored or slightly darker and can be smooth or wart-like.
- Epidermal inclusion cysts: These are small, smooth bumps that can appear on the scrotum. They are usually flesh-colored and can be filled with a cheesy material.
Do Not Miss Diagnoses
- Genital warts (condyloma acuminatum): Although the patient has never been sexually active, it's still possible to contract genital warts through non-sexual contact or vertical transmission. Genital warts can appear as flesh-colored papules, and it's essential to rule out this diagnosis due to its potential for malignancy and transmission.
- Molluscum contagiosum: This is a viral infection that can cause small, flesh-colored papules on the skin. It's highly contagious and can be spread through skin-to-skin contact or fomites.
Rare Diagnoses
- Lymphangioma circumscriptum: This is a rare condition that can cause clusters of small, flesh-colored papules on the scrotum. It's usually associated with lymphatic malformations.
- Neurofibromas: These are rare, benign tumors that can appear on the scrotum. They are usually flesh-colored and can be smooth or nodular.