Genital ulcer disease: Difference between revisions
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==Overview== | ==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. | 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: | Sexually transmitted diseases characterized as GUD include: | ||
| Line 24: | Line 24: | ||
==Differentiating Genital Ulcer Diseases== | ==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. | |||
<ref name="GUDCDC" /> | |||
{| style="font-size: 90%;" | {| style="font-size: 90%;" | ||
! style="background: #4479BA; padding: 5px 5px;" rowspan=2 | {{fontcolor|#FFFFFF| | ! style="background: #4479BA; padding: 5px 5px;" rowspan="2" | {{fontcolor|#FFFFFF|Clinical Characteristic}} | ||
! style="background: #4479BA; padding: 5px 5px;" colspan=5 | {{fontcolor|#FFFFFF|Sexually Transmitted Disease}} | ! style="background: #4479BA; padding: 5px 5px;" colspan="5" | {{fontcolor|#FFFFFF|Sexually Transmitted Disease}} | ||
|- | |- | ||
! style="background: #4479BA; padding: 5px 5px; width: 200px;" | {{fontcolor|#FFFFFF|Chancroid}} | |||
! style="background: #4479BA; padding: 5px 5px; width: 200px;" | {{fontcolor|#FFFFFF|Genital Herpes}} | |||
! style="background: #4479BA; padding: 5px 5px; width: 200px;" | {{fontcolor|#FFFFFF|Donovanosis}} | |||
! style="background: #4479BA; padding: 5px 5px; width: 200px;" | {{fontcolor|#FFFFFF|LGV}} | |||
! style="background: #4479BA; padding: 5px 5px; width: 200px;" | {{fontcolor|#FFFFFF|Syphilis}} | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | | style="padding: 5px 5px; background: #DCDCDC;" | '''Cause''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | ''[[Haemophilus ducreyi]]'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | [[Herpes Simplex Virus]] (HSV-1 & HSV-2) | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | ''[[Klebsiella|Klebsiella granulomatis]]'' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | ''[[Chlamydia trachomatis]]'' serovars L1, L2, or L3 | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | ''[[Treponema pallidum]]'' | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | | style="padding: 5px 5px; background: #DCDCDC;" | '''Lesion Type''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | [[Papule]] evolving to ulcer | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | [[Vesicle]] evolving to [[ulcer]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Ulcer progressing to [[granuloma]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Self-limited papule or ulcer | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Papule evolving to ulcer | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | | style="padding: 5px 5px; background: #DCDCDC;" | '''Lesion Border''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Crater with irregular, sharp margins | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Circular, sharp margins on erythematous base | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Friable base with sharp, raised, rolled margin | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Shallow, smooth border | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Crater with raised edges, smooth margins | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | | style="padding: 5px 5px; background: #DCDCDC;" | '''Lesion Distribution''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Single or multiple | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Multiple, in group/crop | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Single or multiple | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Single or herpetiform | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Multiple | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | | style="padding: 5px 5px; background: #DCDCDC;" | '''Lesion Texture''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Soft | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | [[Umbilicated lesions|Umbilicated]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Granulomatous | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Firm bump | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Indurated | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | | style="padding: 5px 5px; background: #DCDCDC;" | '''Lesion Tenderness''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Present | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Present | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Absent | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Absent | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Absent | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | | style="padding: 5px 5px; background: #DCDCDC;" | '''Lesion Exudate''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Grey/yellow purulent exudate | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Non-exudative | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Non-exudative but bleeds easily | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Non-exudative | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Non-exudative; non-fluctuant | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | | | style="padding: 5px 5px; background: #DCDCDC;" | '''Lymphadenopathy''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Present and tender in approx. half of patients (typically unilateral) | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Present and tender | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Absent from primary infection; pseudobuboes may occur | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Present and tender | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | Present and non-tender (uni- or bilateral) | ||
|} | |} | ||
== | ==References== | ||
{{Reflist|2}} | |||
[[Category:Disease]] | |||
[[Category:Sexually transmitted diseases]] | |||
[[Category:Bacterial diseases]] | |||
[[Category:Proteobacteria]] | |||
Latest revision as of 17:48, 18 September 2017
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.