Genital Ulcers in STI

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Genital Ulcers Paul

Primary Syphilitic Chancre:

Primary Syphilitic Chancre Paul

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Primary Syphilitic Chancre Paul

Primary Syphilitic Chancre:

Primary Syphilitic Chancre Sharply demarcated Elevated Round/oval Smooth clean looking floor Indurated base Painless Firm discrete B’l LN Paul

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Herpes Genitalis Paul

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Herpes Genitalis Multiple vesicles Erythematous sharp margin Painful Firm tender b’l lymph node Paul

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Chancroid Paul

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Chancroid Paul

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Chancroid Multiple (usually) Undermined ragged edges Excavated and deep Purulent and necrotic Soft base Very tender Tender unilateral LN Suppurate & rupture through ONE opening Paul

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Lymphogranuloma Venereum Paul

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Lymphogranuloma Venereum Elevated round/oval Tender LN Suppurate Multiloculated abscesses rupture from multiple sinuses Groove sign of Greenblatt Paul

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Lymphogranuloma Venereum Elevated round/oval Tender LN Suppurate Multiloculated abscesses rupture from multiple sinuses Groove sign of Greenblatt Paul

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Donovanosis/ Granuloma inguinale Paul

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Donovanosis / Granuloma inguinale Elevated irregular margin Beefy red granulation – floor Firm base Unilateral pseudobubo Paul

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Syphilitic chancre Herpes genitalis Chancroid LGV Donovanosis IP 2-4 wks 2-7 days 1-5 days 3 d- 6 wks 1-4 wks Initial lesion Papule Vesicle Papule/ pustule Papule , pustle / Vesicle Papule Subcutaneous nodule Number One Multiple Multiple One Variable Size (mm) 5-15 1-2 2-20 2-10 Variable Edge/margin Sharply Demarcated , Round/oval Erythematous Sharp Undermined Ragged Irregular Elevated Round Oval Elevated Irregular Depth Superficial/ Deep Superficial Excavated and Deep Superficial Elevated Irregular Floor Smooth, Clean looking Serous Erythematous Purulent Necrotic Variable Beefy red granulation Base Indurated None Soft Firm Firm Tenderness Painless Common Very tender Variable Uncommon LNpathy Firm , discrete Shotty , Bilateral Firm tender Bilateral Tender, Unilateral may suppurate & rupture Tender , Multiloculated abscess rupture from multiple sinuses Pseudobubo Unilateral Paul

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Thank You Paul

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