Differential Diagnosis for Penile Lesion
- Single most likely diagnosis
- Herpes Simplex Virus (HSV) infection: The presence of a fissure-like superficial ulceration, mild burning sensation, and worsening symptoms with intercourse are consistent with a primary HSV infection. The lack of significant erythema, swelling, or discharge also supports this diagnosis.
- Other Likely diagnoses
- Syphilitic chancre: Although less common, a syphilitic chancre can present as a painless ulceration, which might be perceived as a mild burning sensation. The location and lack of discharge or erythema could fit this diagnosis.
- Traumatic ulceration: Given the location and the fact that symptoms worsen with intercourse, a traumatic cause due to friction or minor injury during sexual activity is plausible.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Squamous cell carcinoma: Although rare, any penile lesion, especially if it's a new onset or persistent ulceration, warrants consideration of malignancy. Early detection is crucial for effective treatment.
- Lymphogranuloma venereum (LGV): This is a sexually transmitted infection caused by certain types of Chlamydia trachomatis. It can present with ulceration, although it's often accompanied by lymphadenopathy.
- Rare diagnoses
- Behçet's disease: A rare condition characterized by recurrent oral and genital ulcers, among other symptoms. The presence of a genital ulcer without other typical symptoms (like oral ulcers) makes this less likely but still a consideration in the differential diagnosis.
- Fixed drug eruption: This condition can cause ulcerative lesions in response to certain medications. The lesions typically recur at the same site upon re-exposure to the offending drug.