Differential Diagnosis for White Discharge under Foreskin in a 72-Year-Old Male
Single Most Likely Diagnosis
- Balanitis: This condition, characterized by inflammation of the glans penis, can cause a white discharge under the foreskin, especially in uncircumcised males. It's often related to poor hygiene, infections (bacterial, fungal, or viral), or allergic reactions.
Other Likely Diagnoses
- Smegma accumulation: Smegma is a natural, cheesy secretion found under the foreskin. Inadequate hygiene can lead to its accumulation, causing a white discharge.
- Candidiasis (yeast infection): A fungal infection that can cause a white, cottage cheese-like discharge under the foreskin, often accompanied by itching and redness.
- Bacterial infections: Such as streptococcal or staphylococcal infections, which can cause discharge, although it might not always be white.
Do Not Miss Diagnoses
- Squamous cell carcinoma: Although rare, this type of penile cancer can present with a white discharge under the foreskin among other symptoms like a lump or ulcer. Given its potential severity, it's crucial not to miss this diagnosis.
- Gangrene or necrotizing infections: Infections that can cause tissue death, which might initially present with discharge and progress to more severe symptoms. Prompt diagnosis is critical to prevent serious complications.
Rare Diagnoses
- Leukoplakia: A condition characterized by white patches on the mucous membranes, which can occasionally be found under the foreskin and might be mistaken for a discharge.
- Lichen sclerosis: A chronic inflammatory skin condition that can affect the genital area, potentially causing white, patchy lesions under the foreskin.
- Psoriasis or eczema: Although more commonly associated with skin lesions, in rare cases, these conditions can cause a white discharge under the foreskin due to the accumulation of skin cells and secretions.