Genital ulceration

Genital ulceration can represent one of the more complex presentations encountered within genitourinary medicine. There are a wide range of causes, which can make accurate diagnosis a challenge. These include common and rare sexually transmitted infections (STIs), dermatological conditions and trauma. This chapter aims to provide an overview of genital ulceration secondary to STIs. The most common causes of genital ulceration secondary to STI diagnoses in the developed world are genital herpes, primary syphilis and lymphogranuloma venereum. Rarer STI presentations of donovanosis and chancroid typically present in travellers returning from endemic areas. We highlight the typical course and pattern of symptoms for each diagnosis alongside relevant diagnostic tests and current recommended treatment regimens. When not caused by an STI, genital ulceration can occur following local trauma or as a manifestation of an underlying dermatological condition.