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Differential Diagnosis for Burning at the Glance, Penis without Dysuria

  • Single most likely diagnosis
    • Urethritis: This condition, often caused by sexually transmitted infections (STIs) like gonorrhea or chlamydia, can lead to symptoms of burning during urination or discomfort in the genital area without necessarily causing dysuria (painful urination). The absence of dysuria does not rule out urethritis, as symptoms can vary.
  • Other Likely diagnoses
    • Balanitis: An inflammation of the glans penis, which can be caused by infections (bacterial, fungal, or viral), allergies, or irritations. Symptoms include redness, swelling, and a burning sensation, which aligns with the described symptoms.
    • Phimosis: A condition where the foreskin cannot be fully retracted over the glans penis. It can cause discomfort, burning, or pain, especially during urination or sexual activity, without necessarily causing dysuria.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Penile Cancer: Although rare, penile cancer can present with a variety of symptoms including pain, burning, or discomfort in the penis. Early detection is crucial for effective treatment.
    • Herpes Simplex Virus (HSV) Infection: Genital herpes can cause burning sensations, pain, and discomfort in the genital area, including the penis, without necessarily causing dysuria. It's essential to consider due to its potential for serious complications and transmission.
  • Rare diagnoses
    • Lichen Sclerosus: A chronic inflammatory skin condition that can affect the genital area, leading to symptoms such as itching, burning, and discomfort. It's less common but should be considered in the differential diagnosis due to its potential for causing significant discomfort and the importance of early treatment.
    • Fixed Drug Eruption: A condition caused by an adverse reaction to medication, which can result in burning sensations and lesions on the genital area, among other sites. It's rare but important to recognize due to its association with medication use.

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