Genital Ulcer
Genital ulcer refers to the symptom characterized by sores/lesions located in the genital area, including the penis, vagina, anus and the perineal area. Every year, more than 20 million new cases of genital ulcer are reported globally. Several infectious diseases such as, herpes, cytomegalovirus, varicella/chickenpox, lymphogranuloma venereum, syphilis, and chancroid, can lead to the development of genital ulcers.1
1. HSV-1 and HSV-2 - See：Genital Herpes
2. Cytomegalovirus (CMV)
Cytomegalovirus (CMV) is a very common virus with a global prevalence of 45-100%.CMV is transmitted by contact with infected bodily fluids (such as saliva, semen, blood and breastmilk), and can be spread through sexual contact. CMV infections usually show only mild or even no symptoms in healthy individuals, but can be life-threatening for people with weakened immune system, such as people with AIDS, with symptoms including ulcers on the vulva or the scrotum. CMV can be passed to the baby from infected mothers during pregnancy and childbirth, causing congenital CMV infection, which could lead to hearing loss, growth retardation and irreversible damage to the nervous system.2-6
3. Varicella/Chickenpox (Varicella zoster virus, VZV)
Varicella zoster virus (VZV), is a type of herpesvirus that causes varicella (chickenpox) and zoster (shingles).
The symptoms of chickenpox
- Fever,
- Tiredness,
- Generalized, itchy rash with small, fluid-filled blisters, which may be located in the genital area
The symptoms of shingles
- Intense pain,
- Rash with small, fluid-filled blisters that develops as a stripe located on one side of the body, such as the torso, eye, neck, face and genital area
A recent study shows that about 11% of genital ulcers were due to VZV infection7
4. Lymphogranuloma venereum
Lymphogranuloma venereum (LGV) is a sexually transmitted disease caused by the bacteria Chlamydia trachomatis serovars L1, L2 or L3. It is more common among men who have sex with men (MSM).8
The symptoms of LGV includes:
LGV symptoms in Men
- Ulcers on the penis
- Swollen and inflamed lymph nodes (bubo) in one side of the inguinal or femoral area
LGV symptoms in Women
- Ulcers on the vulva
- Swollen and inflamed lymph nodes (bubo) in one side of the inguinal or femoral area
For people engaged in receptive anal sex, LGV may also cause:9
- Ulcers in the perianal area
- Abnormal discharge from the rectum/anus
- Bleeding from the rectum/anus
- Pain in the rectum/anus
- Constipation
If left untreated, LGV could result in the formation of anal or rectal fistulae and strictures 10
5. Syphilis - See：Syphilis
6. Chancroid (Haemophilus ducreyi)
Chancroid is a sexually transmitted disease caused by the bacterium Haemophilus ducreyi. Incubation period: from 3 to 5 days, up to 14 days
Chancroid symptoms in Men
- Single or multiple painful ulcers around the head of the penis and on the foreskin
- Painful, swollen or inflamed lymph nodes (bubo) around the genital or inguinal area11
Chancroid symptoms in Women
- Single or multiple painful ulcers on the vulva
- Painful, swollen or inflamed lymph nodes (bubo) around the genital or inguinal area11
Chancroid symptoms for receptive anal sex
- Ulcers in the perianal area
Genital Ulcer Tests
| Price | |
| Essential Genital Ulcer Screening (7 items) | $2550 |
| Comprehensive Genital Ulcer Screening (11 items) | $3250 |
| Genital Ulcer DNA Screening (7 items) | $2250 |
1. (REF: Low N, Broutet N, Adu-Sarkodie Y, Barton P, Hossain M, Hawkes S. Global control of sexually transmitted infections. Lancet. 2006;368(9551):2001–2016.)
2. (REF: Cannon MJ, Schmid DS, Hyde TB. Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection. Rev Med Virol. 2010;20(4):202–13. 10.1002/rmv.655 . )
3. (REF: Griffiths PD. Burden of disease associated with human cytomegalovirus and prospects for elimination by universal immunisation. Lancet Infect Dis. 2012;12(10):790–8. 10.1016/S1473-3099(12)70197-4 .)
4. (REF: Martin, J. M., Godoy, R., Calduch, L., Villalon, G., & JordA, E. (2008). Lipschütz acute vulval ulcers associated with primary cytomegalovirus infection. Pediatric dermatology, 25(1), 113-115.)
5. (REF: Pinca, R., Crawford, R. I., & Au, S. (2016). Cytomegalovirus scrotal ulcer in a renal transplant patient. Journal of cutaneous medicine and surgery, 20(6), 567-569.)
6. (REF: Manicklal S, Emery VC, Lazzarotto T, Boppana SB, Gupta RK. The "silent" global burden of congenital cytomegalovirus. Clin Microbiol Rev. 2013;26(1):86–102. 10.1128/CMR.00062-12 .)
7. (REF: Granato, P. A., DeGilio, M. A., & Wilson, E. M. (2016). The unexpected detection of varicella-zoster virus in genital specimens using the Lyra™ Direct HSV 1+ 2/VZV Assay. Journal of Clinical Virology, 84, 87-89.), while another study reported that as much as 20% of genital ulcer cases were misdiagnosed and mistreated as genital herpes caused by HSV-1 or HSV-2 (REF: Rübben, A., Baron, J. M., & GRUSSENDORF‐CONEN, E. I. (1997). Routine detection of herpes simplex virus and varicella zoster virus by polymerase chain reaction reveals that initial herpes zoster is frequently misdiagnosed as herpes simplex. British Journal of Dermatology, 137(2), 259-261.).
8. (REF: Perine P, Stamm W. Lymphogranuloma venereum. In: Holmes KK, Sparling P, Mardh P, et al., eds. Sexually transmitted diseases. 3rd ed. New York: McGraw-Hill Health Professions Division; 1999: 423–32.).
9. (REF: Martin-Iguacel R, Llibre JM, Nielsen H, et al. Lymphogranuloma venereum proctocolitis: a silent endemic disease in men who have sex with men in industrialised countries. Eur J Clin Microbiol Infect Dis 2010;29:917–25.)
10. (REF: De Vrieze, N. H. N., & De Vries, H. J. C. (2014). Lymphogranuloma venereum among men who have sex with men. An epidemiological and clinical review. Expert review of anti-infective therapy, 12(6), 697-704.)
11. (REF: Lewis, D. A. (2003). Chancroid: clinical manifestations, diagnosis, and management. Sexually transmitted infections, 79(1), 68-71.).
