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Circinate balanitis

This is a specific form of balanitis associated with reactive arthritis, distinguished by its unique serpiginous (snake-like), moist, erythematous plaques with a slightly raised border.

Contact dermatitis

Identified by a history of exposure to an allergen/irritant and a distribution that perfectly matches the contact area, unlike the other endogenous or infectious conditions.

Eczema

Atopic eczema on the penis presents as an ill-defined, itchy, and scaly patch, often in a patient with a history of eczema elsewhere, unlike the distinct morphologies of the other conditions.

Erythroplasia of Queyrat

This is penile carcinoma in situ, distinguished by its persistent, solitary, sharply demarcated, velvety red plaque that is resistant to treatment.

Fixed drug reaction

The key differentiator is the history of a recurrent, solitary, dusky red or violaceous plaque that appears in the exact same spot each time a specific medication is taken.

Lichen planus

Penile lichen planus is characterized by violaceous, annular plaques or papules, often with a lacy white pattern (Wickham's striae) on the glans.

Penile intraepithelial neoplasia

This is a general term for precancerous changes, encompassing Erythroplasia of Queyrat, and is diagnosed by biopsy showing dysplasia, unlike the inflammatory nature of the others.

Psoriasis

Penile psoriasis presents as sharply demarcated, red plaques that characteristically lack the thick silvery scale seen elsewhere on the body.

Zoon's balanitis

This is a specific diagnosis of older, uncircumcised men, presenting as a solitary, sharply defined, shiny, orange-red patch on the glans.

lichen sclerosus

This condition is distinguished by its characteristic porcelain-white, atrophic plaques that can lead to phimosis (inability to retract the foreskin) and scarring.

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