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Differential Diagnosis for Painless Ulcer on Penis

  • Single most likely diagnosis
    • Syphilis (chancre): This is the most common cause of a painless ulcer on the penis, typically appearing as a single, firm, and painless lesion at the site of initial treponemal infection.
  • Other Likely diagnoses
    • Genital herpes: Although typically painful, some cases can present with minimal discomfort, and the ulcers can coalesce to form larger lesions.
    • Lymphogranuloma venereum (LGV): This is a sexually transmitted infection caused by certain types of Chlamydia trachomatis, which can cause painless ulcers or buboes.
    • Chancroid: Although typically painful, some cases can be relatively painless, especially in the early stages.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Squamous cell carcinoma: A rare but potentially deadly cause of penile ulcers, which can be painless in the early stages.
    • Granuloma inguinale (Donovanosis): A rare bacterial infection that can cause painless, beefy-red ulcers on the genitals.
  • Rare diagnoses
    • Behçet's disease: A rare autoimmune disorder that can cause painless ulcers on the genitals, among other symptoms.
    • Aphthous ulcers: Rarely, aphthous ulcers (canker sores) can occur on the genitals, including the penis, and may be painless.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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