(BQ) Part 2 book “ABC of sexually transmitted infections” has contents: Genital ulcer disease, genital growths and infestations, viral hepatitis, systemic manifestations of STIs, diagnosis of sexually transmitted infections, care of specific risk groups, sexual health care in resource poor settings, and other contents. | C H A P T E R 12 Genital Ulcer Disease Raj Patel 1 and Nadi Gupta 2 1 2 Royal South Hants Hospital, Southampton, UK Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK OVERVIEW Genital herpes • Genital herpes is the most common cause of sexually acquired genital ulceration in the UK • HSV-1 infection is the most common cause of first episode genital ulceration in young people • Most patients with HSV-2 infection will have recurrent disease • Effective strategies exist to diminish transmission risk Lymphogranuloma venereum • LGV outbreaks continue to arise in men who have sex with men • Diagnosis should be suspected in patients presenting with anorectal symptoms Chancroid and donovanosis • These tropical STIs are both rare in the UK Genital ulcer disease represents one of the more complex clinical problems in sexual health care. Genital ulceration may be caused by sexually transmitted infections (STIs), other infectious agents, dermatological conditions, or trauma. The list of differential diagnoses is extensive and can be divided into those that are painful or painless and whether the ulcer is solitary or multiple (Figure ), although exceptions do exist. Sexual history-taking can establish or exclude particular risk factors for many of the rarer causes such as tropical STIs. Although many dermatological causes can occur, most have typical manifestations in non-genital sites. The most common STI causes of genital ulceration in the developed world are genital herpes, primary syphilis (see Chapter 13), and lymphogranuloma venereum. Cases of donovanosis and chancroid tend to only be seen as imported STIs in travellers, although epidemics in closed communities occasionally occur. Genital herpes Genital herpes is a common infection caused by herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2). These viruses are closely ABC of Sexually Transmitted Infections, Sixth Edition. Edited by Karen E. Rogstad. © 2011 Blackwell Publishing Ltd. .
