GUD syndrome | Etiologic agent | Classic ulcer characteristics | Incubation | Pain | Adenopathy |
HSV | HSV-1 and HSV-2 | Multiple small grouped ulcers; erythematous base. Occasionally, single lesions/fissures can be seen | 2 to 7 days | Usually painful; can be painless or pruritic | Reactive painful nodes common |
Vesicles can open, forming shallow ulcers/erosions that may coalesce | |||||
Syphilis | Treponema pallidum | Indurated, smooth firm borders | 7 to 90 days | Usually painless; rarely can be painful | Firm, rubbery nodes |
Clean base | Not tender | ||||
Heals spontaneously | Regional | ||||
Usually singular, although multiple chancres can occur | Discrete | ||||
Chancroid | Haemophilus ducreyi | Sharply circumscribed or irregular, ragged undermined edges | 3 to 10 days | Marked | 50 percent with inguinal adenopathy |
Not indurated | Usually unilateral | ||||
Base may have gray or yellow exudate | Often painful | ||||
Multiple ulcers | May suppurate/rupture | ||||
LGV | Chlamydia trachomatis L1-L3 | Usually not observed | 5 to 21 days | Usually painless | More common in males |
Small and shallow | Matted clusters | ||||
Rapid spontaneous healing | Unilateral or often bilateral | ||||
Large painful fluctuant "buboe" | |||||
Painful groove sign | |||||
Sinus tracts common | |||||
Granuloma inguinale | Klebsiella granulomatis | Extensive, progressive | 7 to 90 days | Usually painless | Pseudobuboes |
Granulation-like tissue | |||||
Rolled edges |
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