Genital ulcer disease (GUD) is a syndrome based on one or more genital ulcers. In a resource-poor setting a specific diagnosis may not be readily available, requiring management based on clinical features alone.
Patient selection: genital ulcer disease
Classic sexually-transmitted diseases:
(1) syphilis
(2) chancroid
(3) lymphogranuloma venereum (LGV)
(4) granuloma inguinale
(5) Herpes simplex virus (HSV)
Other conditions to consider:
(1) amebiasis
(2) leishmaniasis
(3) squamous cell carcinoma
(4) trauma
(5) Behcet's syndrome
(6) Wegener's granulomatosis
(7) fixed drug eruption
(8) psoriasis
(9) secondary bacterial infection
(10) fungal or yeast infection
The presence of GUD increases the risk of HIV transmission.
Problem areas:
(1) chronic ulcerations
(2) failure to respond to therapy
(3) mixed cause (more than one underlying process)
(4) impact of concurrent HIV infection on host response and clinical appearance
(5) reinfection
