Differential Diagnosis for Throat Pain and Raised Black Lesion on Tongue
- Single most likely diagnosis
- Traumatic ulcer: The patient's history of scalding his mouth on hot liquids prior to symptoms makes a traumatic ulcer a likely diagnosis. The raised black lesion could be a result of the burn, and the throat pain and odynophagia are consistent with this diagnosis.
- Other Likely diagnoses
- Infectious ulcers (e.g. herpes simplex, fungal infections): These could be secondary to the initial trauma, and the patient's symptoms of throat pain and odynophagia could be exacerbated by the infection.
- Aphthous ulcers: Although less likely given the patient's history of trauma, aphthous ulcers could still be a consideration, especially if the patient has a history of recurrent aphthous stomatitis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Squamous cell carcinoma: Although the patient's age and other risk factors are not provided, it is essential to consider the possibility of oral cancer, especially given the duration of symptoms (3 weeks) and the presence of a raised black lesion.
- Angina bullosa hemorrhagica: This is a rare condition characterized by the sudden onset of oral bleeding, which could be life-threatening if not promptly treated.
- Rare diagnoses
- Melanoma: Although rare, oral melanoma could present as a raised black lesion, and it is essential to consider this possibility, especially if the lesion is pigmented and has irregular borders.
- Erythema multiforme: This is a rare condition characterized by the presence of target lesions, which could be mistaken for a traumatic ulcer or infectious process.
- Oral hairy leukoplakia: This is a rare condition associated with Epstein-Barr virus infection, which could present as a raised white or black lesion on the tongue.