Sexually transmitted infections: Warts and ulcers: Pathology review
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Sexually transmitted infections: Warts and ulcers: Pathology review
Reproductive system
Male and female reproductive system disorders
Precocious puberty
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Klinefelter syndrome
Turner syndrome
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5-alpha-reductase deficiency
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Male reproductive system disorders
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Male hypoactive sexual desire disorder
Female reproductive system disorders
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Krukenberg tumor
Sex cord-gonadal stromal tumor
Surface epithelial-stromal tumor
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Endometriosis
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Endometrial cancer
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Pelvic inflammatory disease
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Female sexual interest and arousal disorder
Orgasmic dysfunction
Genito-pelvic pain and penetration disorder
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Intraductal papilloma
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Congenital rubella syndrome
Neonatal sepsis
Neonatal meningitis
Miscarriage
Gestational trophoblastic disease
Ectopic pregnancy
Fetal hydantoin syndrome
Fetal alcohol syndrome
Reproductive system pathology review
Disorders of sex chromosomes: Pathology review
Prostate disorders and cancer: Pathology review
Testicular tumors: Pathology review
Uterine disorders: Pathology review
Ovarian cysts and tumors: Pathology review
Cervical cancer: Pathology review
Vaginal and vulvar disorders: Pathology review
Benign breast conditions: Pathology review
Breast cancer: Pathology review
Complications during pregnancy: Pathology review
Congenital TORCH infections: Pathology review
Disorders of sexual development and sex hormones: Pathology review
Amenorrhea: Pathology Review
Testicular and scrotal conditions: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
HIV and AIDS: Pathology review
Penile conditions: Pathology review
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Sexually transmitted infections: Warts and ulcers: Pathology review
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The patient is started on appropriate pharmacologic treatment, but she returns to the clinic two days later after experiencing a continued fever plus chills, headaches, myalgias, and worsening of the maculopapular rash. Which of the following is the most likely diagnosis?
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Antonella Melani, MDContributors
Jahnavi Narayanan, MBBS
Evan Debevec-McKenney
Cassidy Dermott
Jung Hee Lee, MScBMC
A 35 year old female named Rae comes to the clinic one day with complaints of multiple verrucous skin lesions that have appeared over the anogenital region. Upon further questioning, Rae tells you that her husband also developed the same lesions over the same region a few weeks ago, but hasn’t seeked medical attention. On physical examination, you notice that the skin lesions are soft and flesh-colored, and have a unique cauliflower-like appearance. You decide to perform a biopsy of the lesion, which reveals the presence of multiple vacuolated epithelial cells with enlarged, irregular nuclei.
A few days later, a 30 year old male named Mark comes to the clinic concerned about a painful ulcer that recently developed in his genital region. Upon further questioning, he mentions that he’s sexually active, but doesn’t always use protection. On examination of the genital region, you notice that the ulcer is covered by exudate; in addition, Mark has inguinal lymphadenopathy, which is tender. You obtain a sample of the exudate and order a gram staining, which shows gram-negative, rod-shaped bacteria arranged in parallel strands.
Now, based on the initial presentation, Rae has warts, while Mark has ulcers, and both cases seem to be caused by a sexually transmitted infection, or STI for short.
STIs are mainly transmitted from person to person during sexual contact through body fluids, such as vaginal secretions, semen, or blood. The ones most at risk of contracting an STI are sexually active individuals, particularly those who have unprotected sex or multiple sexual partners. But, it’s important to note that sexually transmitted infections can also be transmitted via contact with skin or mucous membranes, including eyes, mouth, throat, and anus. And that’s a high yield fact!
Now, a common STI that may cause warts, called condylomata acuminata, is caused by human papillomavirus, or HPV.
On the other hand, STIs that may cause ulcers include genital herpes, caused by herpes simplex virus, or HSV; syphilis caused by Treponema Pallidum; lymphogranuloma venereum, which is caused Chlamydia Trachomatis; granuloma inguinale caused by Klebsiella granulomatis; and chancroid, which is caused by Haemophilus ducreyi.
Summary
Sexually transmitted infections (STIs) are infections that are spread from person to person through sexual contact. Some can cause the formation of characteristic physical features, such as genital warts and ulcers. One STI that's known to cause warts, called condylomata acuminata, is caused by human papillomavirus, or HPV. On the other hand, STIs that may cause ulcers are numerous. They include genital herpes, caused by herpes simplex virus; syphilis caused by Treponema Pallidum; lymphogranuloma venereum, which is caused by Chlamydia Trachomatis; granuloma inguinale caused by Klebsiella granulomatis; and chancroid, which is caused by Haemophilus ducreyi. Treatment of ulcers focuses on threatening the underlying cause, whereas in condylomata acuminata, you treat the culprit microorganism, and remove the wart with topical medications like imiquimod, or techniques like cryotherapy or surgical excision.
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