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:
Other conditions that are not sexually transmitted infections that may be associated with genital, anal, and perianal lesions include:[1]
Differentiating Genital Ulcer Diseases
Sexually transmitted diseases characterized as GUD may present with similar manifestations and lesion characteristics. 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 laboratory tests to make a definitive diagnosis. [1]
| Clinical Characteristic | Sexually Transmitted Disease | ||||
|---|---|---|---|---|---|
| Chancroid | Genital Herpes | Donovanosis | LGV | Syphilis | |
| Cause | Haemophilus ducreyi | Herpes Simplex Virus (HSV-1 & HSV-2) | Klebsiella granulomatis | Chlamydia trachomatis serovars L1, L2, or L3 | Treponema pallidum |
| Lesion Type | Papule evolving to ulcer | Vesicle evolving to ulcer | Ulcer progressing to granuloma | Self-limited papule or ulcer | Papule evolving to ulcer |
| Lesion Border | Crater with irregular, sharp margins | Circular, sharp margins on erythematous base | Friable base with sharp, raised, rolled margin | Shallow, smooth border | Crater with raised edges, smooth margins |
| Lesion Distribution | Single or multiple | Multiple, in group/crop | Single or multiple | Single or herpetiform | Multiple |
| Lesion Texture | Soft | Umbilicated | Granulomatous | Firm bump | Indurated |
| Lesion Tenderness | Present | Present | Absent | Absent | Absent |
| Lesion Exudate | Grey/yellow purulent exudate | Non-exudative | Non-exudative but bleeds easily | Non-exudative | Non-exudative; non-fluctuant |
| Lymphadenopathy | Present and tender in approx. half of patients (typically unilateral) | Present and tender | Absent from primary infection; pseudobuboes may occur | Present and tender | Present and non-tender (uni- or bilateral) |
References
- ↑ 1.0 1.1 2015 Sexually Transmitted Diseases Treatment Guidelines. Centers for Disease Control and Prevention (June 4, 2015). http://www.cdc.gov/std/tg2015/genital-ulcers.htm Accessed February 2, 2016.