Differential Diagnosis for Painful Sore on Tip of Penis in Older Male
- Single Most Likely Diagnosis
- Herpes Simplex Virus (HSV) infection: This is a common cause of painful sores on the genitals, including the tip of the penis, especially in older adults who may have decreased immunity.
- Other Likely Diagnoses
- Syphilis (primary stage): Characterized by a painless chancre, but can sometimes be painful, especially if secondary infected. It's a consideration due to the rise in syphilis cases among older adults.
- Genital herpes (other types): Besides HSV, other herpes viruses can cause similar symptoms, though less common.
- Balanitis: An inflammation of the glans penis, often caused by poor hygiene, infections (bacterial or fungal), or irritants. It can present with pain and a sore appearance.
- Do Not Miss Diagnoses
- Squamous Cell Carcinoma: Although rare, any persistent or non-healing sore on the penis should raise suspicion for cancer, especially in older males or those with a history of HPV infection.
- Lymphogranuloma Venereum (LGV): A sexually transmitted infection caused by certain types of Chlamydia trachomatis, which can cause genital ulcers and is important to diagnose due to its potential for serious complications if untreated.
- Rare Diagnoses
- Behçet's Disease: A form of vasculitis that can cause genital ulcers, among other symptoms. It's rare but should be considered in patients with recurrent or atypical ulcers.
- Fixed Drug Eruption: A skin condition that can cause lesions or sores in response to certain medications, which can appear on the genitals, including the penis.
- Granuloma Inguinale (Donovanosis): A bacterial infection that causes genital ulcers, more common in tropical regions but can be seen in travelers or immigrants from these areas.