Lumps, bumps and genital ulceration

Question 1

Herpes simplex

Answer 1

Virus lays dormant in basal ganglia
Recurrent outbreaks confined to original dermatome, rates fall with time

Tingle prodrome

Painful ulcerations

20% asymptomatic

Question 2

HSV1 presentation and recurrence rate

Answer 2

Genital ulcers and mouth ulcers

Recurrence rate ~ 1 per year

Question 3

HSV2 presentation and recurrence rate

Answer 3

Anogenital ulcers

Recurrence rate ~4 per year

Question 4

Management of HSV

Answer 4

Salt water bath

Topical anaesthetic

Aciclovir 400mg TDS for 5 days

Question 5

Condyloma lata

Answer 5

Secondary syphilis - painless, mucosal wart like lesions on genitals (warm and wet parts)

= highly contagious

Question 6

Molluscum contagiosum

Answer 6

Viral infection –> Flesh coloured papules - often umbilicated
Asymptomatic unless infected

Self-limiting (up to 6 months)
Can try cryotherapy

Question 7

Pearly Penile papule

Answer 7

Normal variant

Flesh coloured/white 1-2mm papules around corona (proximal glans)

Question 8

Genital warts

Answer 8

HPV 6 + 11
Skin tag-like lesions in clusters
Painless

Treatment - ablative (may be several sessions)