Genital ulcer disease: A review

Abstract

Genital ulcer disease (GUD) continues to be an important cause of morbidity and mortality worldwide. It is an important risk factor for the acquisition of HIV. GUD is mainly caused by five sexually transmitted infections. Three pathogens most frequently associated with GUD are herpes simplex virus 2 (HSV-2), Treponema pallidum , and Haemophilus ducreyi . Although their prevalence varies among different geographical regions, HSV-2 is the leading cause of this syndrome globally. In recent years, there has been an epidemiological transition of HSV-1 with a growing role of this virus as a causative agent of GUD. GUD may present with unique features depending on the etiological agent that can help clinicians identify the etiology and start treatment. However, owing to atypical presentations and co-infections, an accurate clinical diagnosis is often a challenge without confirmatory laboratory tests. Standard methods used to detect the causative pathogens of GUD have limitations. Molecular methods can provide a more sensitive and rapid microbiological diagnosis, with detection of the pathogen from the clinical sample directly. In situations where no laboratory support is available, the syndromic approach for management should be followed. The current scenario, clinical presentation (typical and atypical), laboratory diagnosis, and management of GUD will be discussed in this review. We searched PubMed literature and Google search engine using the terms “genital ulcer disease,” “epidemiology of genital ulcer disease,” and “clinical features of genital ulcer disease and atypical presentations” and relevant literature was selected to provide current perspectives of GUD.

Chancroid: A Tenacious Old Foe of Mankind – Two Cases from the Foothills of the Himalayas

“…Prior to the year 2000, Chancroid was the most prevalent GUD found in STD clinics, with a prevalence of 0 to 69%. 8 Currently, the prevalence of this disease has declined to <10% in India and other countries like USA, Jamaica, Dominican Republic. 8 From 2014 to 2016, few cases were documented in England, Paris, and the Czech Republic.…”

“…8 Currently, the prevalence of this disease has declined to <10% in India and other countries like USA, Jamaica, Dominican Republic. 8 From 2014 to 2016, few cases were documented in England, Paris, and the Czech Republic. [9][10][11] The probable causes for reduction in the number of cases are, increased sexual health awareness public health measures, major changes in the socioeconomic status and introduction of syndromic management, respectively.…”

Alta seroprevalencia de sífilis y herpes genital en migrantes en tránsito en Chiapas, México

“…Así mismo, la coinfección VIH/VHS-2 es muy importante, debido a la sinergia entre ambas infecciones, que de manera recíproca afecta la historia natural de ambos padecimientos, e incrementa la transmisión de uno y otro ( 26 ). El tener sífilis se asoció a una mayor frecuencia de VHS-2, posiblemente por la presencia de lesiones o micro lesiones que ocasiona la sífilis lo que facilita la adquisición de VHS-2 ( 27 ), además de que ambas infecciones presentan comportamientos sexuales de riesgo similares. La frecuencia de VHS-2 se ha empleado como un biomarcador de comportamiento sexual a nivel poblacional, indicando que la población migrante presenta una alta vulnerabilidad para la adquisición de diversas ITS como sífilis, herpes e inclusive VIH ( 28 ).…”