Differentiating Common Sexually Transmitted Genital Lesions
Finding | Other Features | Cause* |
|---|---|---|
Solitary painless ulcer | Indurated, nontender or only slightly tender Relatively nontender inguinal lymphadenopathy | |
Clusters of small, painful, superficial ulcers on an erythematous base | Sometimes with vesicles In a primary episode, often inguinal lymphadenopathy and/or fever | |
Shallow, painful ulcer | Nonindurated, tender ulcers with ragged, undermined edges and an erythematous border, varying in size and often coalescing Regional adenopathy | |
Small papule or ulcer, often asymptomatic or unnoticed | Severely tender and painful adenopathy, sometimes with distal lymphedema or drainage to the skin Sometimes fever | |
Elevated nodule that ulcerates and progressively expands | Velvety, malodorous, granulating lesions No inguinal lymphadenopathy | |
Multiple, shallow ulcers | Characteristic extragenital lesions and burrows | Excoriated scabies |
Multiple, shallow lesions | Visible lice, or egg sacs (nits) attached to hair shafts | Pediculosis pubis with excoriation |
* Other causes of ulcers include oral mucous patches of secondary syphilis, erosive balanitis, gummatous ulceration of tertiary syphilis, Behçet syndrome, epithelioma, and trauma. | ||