Genital ulcers may be due to an infectious or noninfectious etiology, although most are caused by sexually transmitted infections . The prevalence of specific pathogens differs depending upon geographic location. The diagnosis of the cause of genital ulcers is complicated by the fact that more than one infection may coexist. In addition, the presence of genital ulcers is a risk factor for the transmission of HIV. The challenge for the clinician is to determine the cause of the genital ulcers in order to institute appropriate therapy and to decrease the risk of transmission to others.
The approach to the patient with genital ulcers is discussed below. More detailed information regarding the individual diseases can be found on the relevant topic reviews. (See "Diagnostic testing for syphilis" and "Laboratory monitoring of patients undergoing treatment for syphilis" and "Chancroid" and "Epidemiology, clinical manifestations, and diagnosis of genital herpes simplex virus infection" and "Treatment of genital herpes simplex virus infection" and "Lymphogranuloma venereum".)
Infectious — Infectious etiologies of genital ulcers include sexually transmitted pathogens, such as [2-4]:
●Herpes simplex virus (HSV)
●Treponema pallidum (the causative agent of syphilis)