Genital ulcer disease: A review

• Published in: Journal of family medicine and primary care Vol. 11; no. 8; pp. 4255 - 4262
• Main Authors: Ahmed, Jaweed, Rawre, Jyoti, Dhawan, Neha, Dudani, Pankhuri, Khanna, Neena, Dhawan, Benu
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-08-2022; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Disease transmission; Epidemiology; Gastrointestinal diseases; genital ulcer disease; haemophilus ducreyi; Health aspects; herpes simplex virus; Review; Risk factors; Sexually transmitted diseases; sexually transmitted infections; treponema pallidum; South Africa; India; herpes simplex virus; haemophilus ducreyi; treponema pallidum; sexually transmitted infections; Genital ulcer disease
• ISSN: 2249-4863; 2278-7135
• DOI: 10.4103/jfmpc.jfmpc_2111_21

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.