Clinical Case Database / Category: Patient Management

Differential diagnosis of infectious genital lesions

Publication details

Dr Victoria L Parker, Dr William A Parker, Mr Khaled Farag
Foundation Years Journal, volume 9, issue 5, p.24 (123Doc Education, London, May 2015)


Genital lesions are a common condition (>20 million cases worldwide each year) (1), which may present to a variety of medical specialties including Accident and Emergency, Genito-urinary medicine, Obstetrics and Gynecology or Primary Care. Lesions may have an infectious or non-infectious aetiology, and it is crucial that doctors perform a structured history and examination to optimize management and prevent misdiagnosis. The most common infectious genital lesion is genital herpes or warts, although the prevalence of previously uncommon conditions (eg: syphilitic lesions) is gradually increasing. This article will discuss the salient points of medical review and clinical investigation to help physicians pinpoint the diagnosis and optimise patient management.

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Dr Victoria L Parker (Corresponding author)

Department of Obstetrics and Gynaecology
Doctors Office, Level 3, Jessop Wing
Tree Root Walk, Sheffield, S10 2SF

Dr William A Parker

Department of Infectious Diseases and Tropical Medicine
Royal Hallamshire Hospital
Glossop Road, Sheffield, S10 2JF

Mr Khaled Farag

Department of Obstetrics and Gynaecology
Barnsley Hospital, Barnsley, S75 2EP


1. 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. Roett MA, Mayor MT, Uduhiri KA. Diagnosis and management of genital ulcers. American Family Physician. Feb 1st 2012.
3. Clinical Effectiveness Group (British Association for Sexual Health and HIV) (2007). National guideline for the management of genital herpes. Accessed via
4. Kingston M, French P, Goh B, Goold P, Higgins S, Sukthankar A, Stott C, Turner A, Tyler C, Young H (2008). UK National Guidelines on the Management of Syphilis. International Journal of STD & AIDS 19:(729-740)
5. O'Farrell N, Lazaro N. (2014). UK national guideline for the management of chancroid. International Journal of STD & AIDS. 25:975-983
6. White J, O'Farrell N, Daniels D (2013). 2013 UK National Guideline for the management of lymphogranuloma venereum. International Journal of STD & AIDS 24:593-601
7. Clinical Effectiveness Group (British Association for Sexual Health and HIV) (2011). United Kingdom national guideline for the management of Donovanosis (Granuloma inguinale). Accessed via
8. Clinical Effectiveness Group (British Association for Sexual Health and HIV) (2007). United Kingdom national guideline on the management of ano-genital warts. Accessed via


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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