Genital ulcer disease

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A.

Synonyms and keywords: GUD

Overview

Genital ulcer disease (GUD) can be defined as diseases characterized by genital, anal, or perianal lesions that are ulcerative or pustular. GUD is typically caused by sexually transmitted infections (STI) but also by other non-STI conditions.

Sexually transmitted diseases characterized as GUD include:

• Chancroid
• Genital herpes
• Donovanosis (granuloma inguinale)
• Lymphogranuloma venereum (LGV)
• Syphilis

Other conditions that are not sexually transmitted infections that may be associated with genital, anal, and perianal lesions include:

• Genital candidiasis
• Trauma
• Carcinoma
• Aphthae
• Fixed drug eruption
• Psoriasis
• Behçet's disease

Differentiating Genital Ulcer Diseases

Manifestation	Sexually Transmitted Disease
	Chancroid	Genital Herpes	Donovanosis	LGV	Syphilis

Laboratory Testing

A diagnosis based only on the patient’s medical history and physical examination frequently is inaccurate. Patients who have genital, anal, or perianal ulcers should be evaluated with, but not limited to, the following tests:

1. Syphilis serology and darkfield examination
2. Culture for HSV or PCR testing for HSV
3. Serologic testing for type-specific HSV antibody
4. Culture for Haemophilus ducreyi in areas of high chancroid prevalence