Differential Diagnosis for Tip of Penis in a 19-year-old
Single most likely diagnosis
- Balanitis: This is an inflammation of the glans (tip) of the penis and is common in young men, especially those who are uncircumcised. It can be caused by poor hygiene, infections (bacterial, fungal, or viral), or allergic reactions.
Other Likely diagnoses
- Phimosis: A condition where the foreskin cannot be fully retracted over the glans, which can lead to irritation, inflammation, or infection at the tip of the penis.
- Urethritis: Inflammation of the urethra, which can cause symptoms like discharge, pain during urination, and sometimes redness or swelling at the tip of the penis.
- Herpes Simplex Virus (HSV) infection: Genital herpes can cause painful blisters or ulcers on the penis, including the tip.
- Syphilis: A sexually transmitted infection that can cause a painless sore (chancre) on the penis, often on the tip.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Squamous Cell Carcinoma: Although rare in young men, any unusual or persistent lesion on the penis should be evaluated for cancer.
- Gangrene: Infections like balanitis can rarely progress to gangrene if not properly treated, especially in individuals with underlying health conditions like diabetes.
- Lymphogranuloma Venereum (LGV): A sexually transmitted infection caused by certain strains of Chlamydia trachomatis, which can lead to serious complications if not treated.
Rare diagnoses
- Behçet's Disease: A rare condition that can cause ulcers on the genitals, including the penis, as well as other parts of the body.
- Fixed Drug Eruption: A rare skin condition that can cause lesions on the penis in response to certain medications.
- Peyronie's Disease: Although more common in older men, this condition involves the development of scar tissue inside the penis, leading to curved, painful erections, and could potentially cause discomfort or deformity at the tip of the penis.