Differential Diagnosis for Fatigue, Papular Lesions, Mouth Ulcers, Abdominal Pain, and Globus

• Single Most Likely Diagnosis

  • Behçet's Disease: This condition is characterized by a combination of symptoms including mouth ulcers, genital ulcers, skin lesions, and eye inflammation. The presence of mouth ulcers, papular lesions on the chest wall, and possibly abdominal pain due to gastrointestinal involvement aligns with Behçet's Disease. Fatigue is also a common symptom due to chronic inflammation.

• Other Likely Diagnoses

  • Systemic Lupus Erythematosus (SLE): SLE can present with a wide range of symptoms including fatigue, mouth ulcers, skin rashes (which could be papular), abdominal pain, and potentially globus sensation due to esophageal involvement. The disease's variability and potential to affect multiple systems make it a plausible diagnosis.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause abdominal pain, fatigue, and potentially mouth ulcers (less common but possible, especially in Crohn's disease). Skin manifestations and the sensation of globus could be related to extraintestinal manifestations or complications of IBD.

• Do Not Miss Diagnoses

  • Cancer (e.g., Lymphoma): Certain types of cancer, particularly lymphoma, can present with a variety of systemic symptoms including fatigue, abdominal pain (due to organ involvement), and skin lesions. Mouth ulcers could be a sign of tumor infiltration or paraneoplastic syndrome. Although less likely, missing a diagnosis of cancer could be catastrophic.
  • Infectious Diseases (e.g., Tuberculosis, HIV): Both tuberculosis and HIV infection can cause a wide range of symptoms including fatigue, abdominal pain, skin lesions, and mouth ulcers. These conditions are critical to identify due to their significant impact on morbidity and mortality if left untreated.

• Rare Diagnoses

  • Sarcoidosis: This is a condition characterized by the growth of granulomas in various parts of the body. It can cause fatigue, skin lesions, abdominal pain (if the gastrointestinal tract is involved), and potentially mouth ulcers. While less common, sarcoidosis is a diagnosis to consider in patients with multi-system symptoms.
  • Sweet Syndrome: Also known as acute febrile neutrophilic dermatosis, Sweet syndrome can cause fever, fatigue, and characteristic skin lesions, along with mouth ulcers in some cases. Abdominal pain could be related to associated conditions or complications. It's a rare condition but should be considered in the differential diagnosis due to its unique presentation.