Differential Diagnosis for Penile Lesions
- Single most likely diagnosis
- Genital warts (caused by Human Papillomavirus): This is a common condition that can cause visible lesions on the penis, often presenting as small, flesh-colored bumps. The high prevalence of HPV and the frequency of genital warts make this a likely diagnosis for penile lesions.
- Other Likely diagnoses
- Herpes simplex virus (HSV) infection: HSV can cause painful lesions or blisters on the penis. Given the prevalence of HSV and its potential for genital involvement, this is a plausible diagnosis.
- Syphilis (primary stage): The primary stage of syphilis is characterized by a chancre, which is typically a single, painless lesion on the genitals. Although less common than some other sexually transmitted infections, syphilis remains a significant concern.
- Balanitis: This is an inflammation of the glans penis, often caused by poor hygiene, infections (bacterial or fungal), or irritants. It can present with lesions, redness, and discomfort.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Penile cancer: Although rare, penile cancer can present with lesions on the penis. Early detection is crucial for effective treatment, making it essential not to miss this diagnosis.
- Lymphogranuloma venereum (LGV): This is a sexually transmitted infection caused by certain strains of Chlamydia trachomatis. It can cause lesions, but more importantly, it can lead to serious complications if not treated promptly.
- Rare diagnoses
- Behçet's disease: A rare condition that can cause genital ulcers, among other symptoms. It's an important consideration in patients with recurrent or atypical lesions.
- Fixed drug eruption: A condition where certain medications cause skin lesions, which can appear on the genitals. This is a rare but possible cause of penile lesions.
- Erythema multiforme: An immune-mediated condition that can cause target-like lesions on the skin, including the genitals. It's a rare condition but should be considered in the differential diagnosis of penile lesions.