Differential Diagnosis for White Irregular Lesions on Inner Foreskin with Associated Symptoms
Single Most Likely Diagnosis
- Balanitis: This condition is characterized by inflammation of the glans penis and is often associated with foreskin swelling. The presence of white irregular lesions could be indicative of a fungal or bacterial infection, which is commonly seen in balanitis. The exquisite tenderness, fever, and chills further support this diagnosis.
Other Likely Diagnoses
- Phimosis with superimposed infection: Phimosis is a condition where the foreskin cannot be fully retracted over the glans. If an infection develops, it could lead to the symptoms described, including swelling, tenderness, and fever.
- Urethritis: Inflammation of the urethra could cause pain and discomfort in the genital area, including the inguinal region. However, the primary symptoms would typically involve dysuria and urethral discharge.
- Epididymitis: Although this condition primarily affects the epididymis, causing testicular pain, it could potentially cause referred pain to the inguinal area and systemic symptoms like fever and chills.
Do Not Miss Diagnoses
- Fournier's Gangrene: A severe and potentially life-threatening condition characterized by necrotizing fasciitis of the genitalia. The presence of exquisite tenderness, fever, chills, and swelling, especially if rapidly progressing, should prompt consideration of this diagnosis.
- Testicular torsion: Although the primary symptom is severe testicular pain, it can sometimes present with radiating pain to the inguinal area. The systemic symptoms like fever and chills are less common but could be present in cases of delayed presentation.
Rare Diagnoses
- Lichen sclerosis: A chronic inflammatory skin condition that can affect the genitalia, leading to white, patchy lesions. However, it typically does not present with acute symptoms like fever and chills.
- Squamous cell carcinoma: A type of skin cancer that could present as irregular lesions on the genitalia. While it's rare and less likely to cause systemic symptoms like fever and chills in early stages, it should be considered in the differential diagnosis for new, unexplained lesions.