Genital ulcer

Genital ulcer
Genital ulcer in an immunsupressed patient
ICD-10	GroupMajor.minor
ICD-9	xxx
DiseasesDB	19297

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Evidence Based Medicine
Cochrane Collaboration on Genital ulcer Bandolier on Genital ulcer TRIP on Genital ulcer
Clinical Trials
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Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Genital ulcer NICE Guidance on Genital ulcer NHS PRODIGY Guidance FDA on Genital ulcer CDC on Genital ulcer
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Definitions
Definitions of Genital ulcer
Patient Resources / Community
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List of terms related to Genital ulcer

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: John Fani Srour, M.D.

Overview

A Genital ulcer is an ulcer located on the genital area, caused by a sexually transmitted disease such as genital herpes, syphilis, chancroid, or thrush. Some other signs of having genital ulcers include enlarged lymph nodes in the groin area, or vesicular lesions, which are small, elevated sores or blisters. The syndrome may be further classified into penile ulceration and vulval ulceration for males and females respectively.

Causes

Common Causes

• Balanitis
• Behcet's disease
• Cancer
  • Basal cell carcinoma
  • Squamous cell carcinoma
• Chancroid (Haemophilus ducreyi) (the third most common cause in the USA)
• Excoriations
• Herpes Genitalis HSV-2 and less common HSV-1 (the most common cause in USA)
• HIV-specific ulcers (acute HIV infection or late HIV)
• Human papilloma virus
• Lichen planus
• Neisseria gonorrhoeae
• Pyoderma
• Syphilis (primary syphilis) (the second most common cause in USA)
• Vulvovaginitis

Other Causes (rare)

• Athabaskan severe combined immunodeficiency
• Cicatricial pemphigoid
• Cytomegalovirus infection
• EBV infection
• Erythema multiforme
• Fixed drug eruption
• Foscarnet
• Genital trauma
• Granuloma inguinale (Klebsiella granulomatis)
• Langerhans cell histiocytosis
• Lymphogranuloma venereum (LGV, Chlamydia trachomatis serovars L1-3)
• Pemphigus vulgaris
• Reiter's syndrome
• Scabies
• Stevens-Johnson syndrome
• Strachan's syndrome: orogenital ulceration, sensory neuropathy, amblyopia
• Yeast infection

Complete Differential Diagnosis of the Causes of Genital Ulcers:

(By organ system)

Cardiovascular	No underlying causes
Chemical / poisoning	No underlying causes
Dermatologic	Balanitis, Behcet's disease, Cancer, Basal cell carcinoma, Squamous cell carcinoma, Chancroid, Chlamydia trachomatis, Herpes Genitalis, Lichen planus, Pyoderma, Syphilis, Cicatricial pemphigoid, Erythema multiforme, Excoriations, Fixed drug eruption, Granuloma inguinale, Langerhans cell histiocytosis, Lymphogranuloma venereum, Pemphigus vulgaris, Reiter's syndrome, Scabies, Stevens-Johnson syndrome, Strachan's syndrome
Drug Side Effect	Foscarnet
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	Excoriations
Infectious Disease	Chancroid, Chlamydia trachomatis, Herpes Genitalis, Human papilloma virus, Neisseria gonorrhoeae, Syphilis (primary syphilis), Vulvovaginitis, Cytomegalovirus infection, Granuloma inguinale, Lymphogranuloma venereum, Scabies, Yeast infection, HIV, Klebsiella granulomatis, EBV infection
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	skin cancer, basal cell carcinoma, squamous cell carcinoma, Langerhans cell histiocytosis
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	Behcet's disease, Athabaskan severe combined immunodeficiency, Cicatricial pemphigoid, Erythema multiforme, Fixed drug eruption, Pemphigus vulgaris, Reiter's syndrome, Stevens-Johnson syndrome
Sexual	No underlying causes
Trauma	Genital trauma, Excoriations
Urologic	Balanitis, Cancer, Chancroid, Genital trauma, Granuloma inguinale, Lymphogranuloma venereum, Yeast infection
Miscellaneous	No underlying causes

External Links

• http://www.fhi.org/training/en/modules/STD/s3pg12.htm
• http://www.ubht.nhs.uk/Milne/other_docs/ulcers.pdf
• http://www.findarticles.com/p/articles/mi_m0689/is_12_52/ai_111614749
• http://www.cdc.gov/std/treatment/2006/genital-ulcers.htm