Diferencijalna dijagnoza ulceracija na spolovilu

Patient that presents with genital ulceration may be a great challenge for proper diagnosis and treatment. The most common causes of genital ulcerations are genital herpes and syphilis. But, many other sexually transmitted diseases may cause ulcers such as: ulcus molle (chancroid), lymphogranuloma inguinale, granuloma venerum (donovanosis), human papilloma virus (HPV) infection, scabies and molluscum contagiosum. ----- Non-sexually transmitted dieseases that cause genital ulcers include infectious diseases: Bartholin's cyst, Fournier's gangrene, Lipschutz ulcer, genital tuberculosis, chronic anogenital pyodermia and yeast infection. Mixed infections can also occur and genital ulcer may increase the risk of acquiring human immunodeficiency virus (HIV). ----- Non-infective causes of genital ulcers are irritative and allergic contact dermatitis, lichen simplex chronicus, fixed drug eruptions, Stevens-Johnson syndrome, 'accidental' and self injuries, precancerous genital lesions, genital cancers and other diseases: psoriasis vulgaris/ psoriasis inversa, annular lichen, balanitis circinata, erosive lichen planus, Behcet's disease, pyoderma gangrenosum, morbus Hailey-Hailey, pemphigus chronicus vulgaris, hidradenitis suppurativa, fistula and Zoon balanitis/vulvitis. ----- The history and physical examination can narrow the differential diagnosis, but there is a need for initial routine laboratory testing for the most common pathogens. In many cases only biopsy and histopathological analisys can lead us to the correct diagnosis. ----- 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 thesis reviews infectious and non-infectious genital diseases that present with ulcers, their etiology, epidemiology, clinical presentation, diagnosis and treatment.