Malisiewicz B, Schöfer H
Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Goethe-Universität Frankfurt/M., Theodor-Stern-Kai 7, 60590, Frankfurt/M., Deutschland.
Hautarzt. 2015 Jan;66(1):19-29. doi: 10.1007/s00105-014-3551-3.
BACKGROUND/OBJECTIVES: In this review article the diagnostic and therapeutic principles of genital ulcers of infectious etiology are highlighted. Besides frequent causative infections rare but relevant diseases in the differential diagnosis are discussed in detail.
A Pubmed literature search was carried out, guidelines from different task groups and clinical experiences are presented.
Infections with herpes simplex virus (first) and syphilis (second) are still the most common causes of infectious genital ulcers. An endemic occurrence, previously rare in Europe, has been observed in recent years. Particular risk groups, such as men who have sex with men (MSM), sex workers or sex tourists are affected. Even less common locations, such as the mouth or the rectum, lymphogranuloma venereum (LGV) and atypical clinical symptoms (e.g. pelvic pain in pelvic lymphadenopathy with LGV) must be considered in the differential diagnosis.
In recent years sexually transmitted infections (STI) have shown a significant increase in western industrialized nations. In all cases with unclear findings in the genital and anal areas (and also in the oral cavity) STI diseases must be reconsidered in the differential diagnosis.
背景/目的:在这篇综述文章中,重点介绍了感染性病因导致的生殖器溃疡的诊断和治疗原则。除了常见的致病感染外,还详细讨论了鉴别诊断中罕见但相关的疾病。
进行了PubMed文献检索,并展示了不同任务组的指南和临床经验。
单纯疱疹病毒感染(居首位)和梅毒感染(居第二位)仍然是感染性生殖器溃疡最常见的病因。近年来,在欧洲曾一度罕见的地方性病例有所增加。特定的风险群体,如同性恋男性、性工作者或性旅游者受到影响。在鉴别诊断中,甚至如口腔或直肠等较少见部位、性病性淋巴肉芽肿(LGV)以及非典型临床症状(如LGV伴盆腔淋巴结病时的盆腔疼痛)都必须予以考虑。
近年来,西方工业化国家的性传播感染(STI)显著增加。在生殖器和肛门区域(以及口腔)出现不明病变的所有病例中,鉴别诊断时都必须重新考虑STI疾病。