genital ulcer

Etiology

• sexually transmitted diseases
  • genital herpes simplex (HSV type 1, HSV type 2)
    • multiple 1-2 mm, tender vesicles or erosions
    • tender lymphadenopathy
    • HSV type 2 most common cause of painful genital ulcer
  • chancroid (Haemophilus ducreyi)
    • ragged, purulent, painful ulcers
    • tender inguinal lymphadenopathy
  • granuloma inguinale (Donovanosis)
  • lymphogranuloma venereum (Chlamydia trachomatis)
    • single 0.2-1.0 cm ulcer
    • sometimes painful
    • tender unilateral lymphadenopathy
    • may suppurate
  • syphilis (Treponema pallidum)
    • single, painless 0.5-1.0 cm indurated genital ulcer
    • non-tender bilateral genital inguinal lymphadenopathy
• fixed drug eruptions (NSAIDs, phenobarbital, antibiotics)
  • single or multiple blisters or erosions
  • 1-2 cm in size
  • frequently on glans penis
• chemical irritant
  • sodium hypochlorite

Laboratory

• serology, & either darkfield examination or direct immunofluorescence test for T. pallidum
• culture or antigen test for herpes simplex virus (HSV)
• culture for H. ducreyi
• HIV testing indicated if caused by T. pallidum or H. ducreyi.
  • consider if caused by HSV

Management

see specific etiology

More general terms

• cutaneous ulcer

More specific terms

• vulvar ulcer