Genital Lesions

Painless

Syphilis

(T. pallidum) 1°: chancre = firm, indurated, clean base 2°: fever, LAN, rash palms/soles, uveitis, condylomata lata 3°: aortitis/aneurysm, gumma, CN palsies (7/8), tabes dorsalis, aseptic meningitis Latent = asx; early latent <1yr; late >1yr/unknown

LGV

(C. trachomatis, L1–L3) 1°: transient papule 2°: 2–6 wks later, painful inguinal LN (buboes) 3°: Anorectal syndrome w/ proctitis, ulcers

Donovanosis/GI (K. granulomatis)

Multiple beefy, firm, irregular ulcers (“granuloma inguinale”), no LAN; in tropics

Painful

Genital herpes

(HSV 2>1) Prodrome: multiple painful vesicles 1° outbreak: more severe ± LAN/fever

Chancroid (H. ducreyi)

Multiple ulcers ± LAN, in tropics