Genital Ulcer Disease (GUD)
exp date isn't null, but text field is
This is an ulcerative, erosive, pustular or vesicular genital lesion(s) with or without regional lymphadenopathy; caused by a number of sexually transmitted infections (STIs) and non-STI-related conditions.
Causes
|
STIs |
Non-STI-related infections or conditions |
|
-Herpes Simplex Virus type 1 or 2 (HSV-1 or HSV-2) - Treponema pallidum. causing primary syphilis - Haemophilus ducreyi causing chancroid - Chlamydia trachomatis serotypes L1-L3 causing -Lymphogranuloma venereum (LGV) -Klebsiella granulomatis causing granuloma inguinale (donovanosis) |
-Infectious non-STI-related causes of genital ulcers -Non-infectious non-STI-related causes of genital ulcers |
- Genital ulcer
- Pain
- Urethral discharge
Differential diagnosis
- Cancer of the penis or vulva
Evaluation/Investigations
- Diagnosis is mostly clinical
- Swab for microscopy, culture and sensitivity
- Serology
- Blood for VDRL/TPHA
Treatment objectives
- Treat small ulcers and vesicles, especially if recurrent for Herpes Simplex
- Direct initial management of all ulcers at both syphilis and chancroid
Non-pharmacological treatment
- Keep lesions dry and clean
Pharmacological treatment
For Herpes Simplex
Acyclovir oral
400 mg every 6 hours for 7 days
AND
Paracetamol
500 mg every 6-8 hours or when necessary
In patients with recurrence
Repeat acyclovir, the same dose for 5 days
PLUS
Paint lesions with
Povidone iodine topical
OR
Mercurochrome topical
OR
Gentian violet solution topical
Note:
- If syphilis is present refer to section on syphilis treatment
- If chancroid is present refer to section on chancroid treatment
Referral
- If not responding to treatment refer for specialist care