Differential diagnosis of genital ulcerations

Overview

In the framework of differential diagnostics concerning genital ulceration, it is necessary to think of the specific etiology in the first place – the primary stage of syphilis. Laboratory tests help to determine the diagnosis. Currently the number of recorded cases of fresh forms of syphilis is increasing. Further investigation needs be to carried out to exclude the presence of any other STI. The most frequent causes of ulceration on the exterior of the genitals are non-specific STI: HSV I+II viral infection, erosive balanoposthitis caused by yeast, or a mixture of anaerobic microbes. The manifestation of autoimmune diseases (pemphigus vulgaris or pemphigoid bullosus) or drug toxicoallergic reaction such as Stevens – Johnson syndrome are not uncommon. Histology tests need to be carried out in case of possible ulcerative presence of genital tumours. On rare occasions, genital ulceration belonging to systemic disorders (Behcet and Reiter syndromes), non-venereal treponematosis, or serotypes infection L1, L2, L3 of lymphogranuloma inguinal (venereum) can be found. The diagnosis of ulcer mole and rarely seen forms of syphilis such as chancre redux (II. stage reindurations of secondary infection) and pseudochancre redux (gumma syphiliticum at the of point of ulcer durum without spirochete) needs to be taken into consideration.

Key words:
genital ulcerations, differential diagnosis, syphylis, herpes progenitalis, ulcus molle, balanitis errosiva, lymphogranuloma venereum, tumours, STI, STD