Differential Diagnosis for Redness of the Tip of Penis in an Uncircumcised 7-Month-Old Male

• Single Most Likely Diagnosis
  • Balanitis: This is an inflammation of the glans penis and is common in uncircumcised males due to the warm, moist environment under the foreskin, which can lead to irritation and infection. The age and uncircumcised status of the child make this a highly plausible diagnosis.
• Other Likely Diagnoses
  • Contact Dermatitis: Irritation from diapers, soaps, or other substances can cause redness and inflammation on the penis.
  • Urinary Tract Infection (UTI): Although less common in males, UTIs can cause irritation and redness, especially if the infection involves the urethra.
  • Phimosis: Inflammation or infection can cause the foreskin to become tighter, leading to difficulty retracting it and potentially causing redness and discomfort.
• Do Not Miss Diagnoses
  • Sexually Transmitted Infections (STIs): Although highly unlikely at this age without a clear history of abuse, STIs like gonorrhea or chlamydia can cause penile redness and discharge. It's crucial to consider this possibility to ensure appropriate investigation and protection of the child.
  • Child Abuse: Any genital injury or infection in a child should prompt consideration of non-accidental injury. A thorough investigation, including a detailed history and possibly a multidisciplinary team assessment, is essential.
• Rare Diagnoses
  • Balanoposthitis: An inflammation of both the glans penis (balanitis) and the foreskin (posthitis), which can be more severe and is less common in infants.
  • Fixed Drug Eruption: A rare condition where certain medications cause skin lesions, including on the genitals, upon re-exposure to the drug.
  • Lichen Sclerosus: A chronic inflammatory skin condition that can affect the genital area, leading to thinning and scarring of the skin, although it's more commonly diagnosed in older children and adults.