Differential Diagnosis for a Hard Lesion on the Penis
Single Most Likely Diagnosis
- Fordyce spots: These are small, benign lesions that can appear as hard, white or yellowish bumps on the shaft of the penis. They are very common and usually harmless.
Other Likely Diagnoses
- Pearly penile papules: These are small, hard bumps that appear on the edge of the penis. They are a normal anatomical variation and are not a cause for concern.
- Seborrheic keratosis: A benign skin growth that can appear as a hard, waxy lesion. It is common in older adults and can appear anywhere on the body, including the penis.
- Epidermoid cyst: A small, hard lump that forms when skin cells and keratin become trapped beneath the skin surface. It can appear on the penis and is usually benign.
Do Not Miss Diagnoses
- Squamous cell carcinoma: A type of skin cancer that can appear as a hard, firm lesion on the penis. Although rare, it is crucial to rule out due to its potential severity.
- Melanoma: A type of skin cancer that can appear as a new, changing, or unusual growth on the penis. It is rare but deadly if missed.
- Genital warts (condyloma acuminata): Caused by the human papillomavirus (HPV), these can appear as hard, flat, or cauliflower-like lesions on the penis. They are contagious and can be a precursor to more serious conditions.
Rare Diagnoses
- Merkel cell carcinoma: A rare and aggressive type of skin cancer that can appear as a hard, painless nodule on the penis.
- Dermatofibroma: A rare, benign skin growth that can appear as a hard, firm lesion on the penis.
- Penile calcinosis: A rare condition where calcium deposits form under the skin of the penis, leading to hard lesions.