What is the cause of an ulcer and itching on the glans (penile head)?

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Differential Diagnosis for Ulcer and Itchiness on Penile Head

  • Single most likely diagnosis
    • Genital herpes: This is a common sexually transmitted infection that can cause painful ulcers and itching on the genital area, including the penile head. The presence of multiple small vesicles that rupture to form ulcers is characteristic.
  • Other Likely diagnoses
    • Syphilis: The primary stage of syphilis is characterized by a painless chancre, which is an ulcer on the genital area. However, some patients may experience itching or discomfort.
    • Genital warts: Caused by the human papillomavirus (HPV), these can appear as small, flat, or raised growths on the penis and may cause itching.
    • Eczema/Dermatitis: Contact dermatitis or eczema can cause itching and skin lesions on the penile head, which may appear as ulcers if scratched excessively.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Penile cancer: Although rare, any persistent ulcer on the penis should raise suspicion for penile cancer, especially in uncircumcised men or those with a history of HPV infection.
    • Lymphogranuloma venereum (LGV): A sexually transmitted infection caused by certain strains of Chlamydia trachomatis, which can cause ulcers, lymphadenopathy, and potentially severe complications if not treated.
  • Rare diagnoses
    • Behçet's disease: A rare condition that can cause genital ulcers, among other symptoms like oral ulcers and eye inflammation.
    • Fixed drug eruption: A condition where certain medications cause skin lesions or ulcers at the same site each time the drug is taken, which could potentially occur on the genital area.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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