Genital Ulcers

Syphilis/Primary Chancre

  • Treponema pallidum
  • Incubation period of 9-90 days
  • Usually single lesion
  • Papule, which maybe superficial or deep
  • Edges are sharply demarcated elevated, round or oval.
  • Induration is firm
  • Pain is uncommon
  • Firm nontender bilateral lymphadenopathy

Chancroid

  • Hemophilus ducreyi
  • Incubation period 1-14 days
  • Lesions may be multiple and may coalesce
  • primary lesion is a pustule,excavated
  • Undermined ragged irregular edges
  • base is purulant bleeds easily
  • Soft in consistency
  • Very tender
  • Tender lymphadenopathy,loculated, usually unilateral(bubo)

Lymphogranuloma venereum

  • Chlamydia trachomatis(L1,L2,L3)
  • Incubation period of 3days to 6 weeks
  • Lesion usually single
  • Primary lesion papule or pustule
  • Elevated roun or oval edges
  • Occasionaly firm
  • Tender lymphadenopathy,may suppurate,unilateral(bubo)

Herpes Genitalis

  • Herpes simplex virus Type II
  • Incubation period of 2-7 days
  • recurrent attacks
  • Multiple lesions which may coalesce
  • Primary lesion is a vesicle
  • superficial with erythematous edges
  • Base is serous,erythematous,non vascular
  • frequently tender
  • Firm tender often bilateral lymphadenopathy

Tip: Single lesions in chancre and LGV. All lesions are painful except chancre which is non tender and lymphadenopathy is bilateral. LA bilateral in chancre and herpes genitalis. Unilateral LA in chancroid and LGV. Smallest incubation period for Herpes genitalis and chancroid, while longest for syphilis and LGV.Base purulent and bleeds easily in chancroid.

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