1. Acute genital ulcers
(1) non-specific vulvitis: ulcer mostly occurs in the scratch, the may be associated with low-grade fever and fatigue and other symptoms, local pain seriously. Superficial ulcers, the number of less obvious around inflammation.
(2) herpes virus infection: rapid onset. Contact with herpes simplex virus-source generally have an incubation period of 2 to 7 days after the fever, malaise, inguinal lymph nodes and herpes. The beginning for more than one herpes, herpes ulceration after the pale form of multiple ulcers, with pain. Multi-ulcer involving the labia minora, especially in its internal side, 50% ~ 80% of the cases involving the vagina, urethra, and cervix. Ulcer size, the bottom of the sallow, surrounded by the marginal slightly elevated, and a high degree of congestion and edema. Ulcers often 1 to 2 weeks, natural healing, but often relapse. Herpes simplex virus as involving the vagina, urethra, etc., patients often accompanied by a large number of leucorrhea, leucorrhea the beginning of a transparent slurry, thin turbid pus after the final due to bacterial infection of yellow purulent vaginal discharge, associated with urinary tract symptoms: such as the urgency, urination difficulties.
(3), Behcet's disease: acute genital ulcers is common in Behcet's disease, that is, eyes - mouth - genital syndrome. Over the past that is a kind of acute genital ulcers caused by bacteria thick non-contact infections benign ulcer. Is more than that of acute genital ulcers of Behcet's disease is a development stage, with eyes, mouth lesions occurring simultaneously or successively. Genital ulcer may occur in a wide range of ministries, and to the labia minora and vaginal vestibule in a multi-lateral. Begins abruptly, often relapse. Is divided into three clinical types may occur alone or mixed in order to gangrene, the most serious type.
① gangrene Type: Multi-prior systemic symptoms such as fever and so weak. Inflamed lesion notable, ulcers jagged, there is the phenomenon of wear digging, local pain weight. Ulcer surface with same stuff pus, or dirty yellow to dark gray pseudomembranous necrosis, can be seen after the removal of uneven substrate. Lesions developed rapidly, can cause the labia minora defects, appearance similar to the vulva, but the edge and basal soft, non-invasive.
② chancre type: more common. Generally mild symptoms, course of the disease is slow. The number of ulcers are more shallow. Redness around the ulcer, jagged. May also have to wear the phenomenon of digging. Often healed within a few weeks, but often in the old lesions healed stage, there are new ulcers occur in the vicinity.
③ miliary type: ulcers, such as needle to the grain size, the number more. Healed quickly. Mild symptoms.
(4) sexually transmitted diseases such as syphilis, chancroid, and venereal lymphogranuloma can cause genital ulcers.
① Syphilis: Syphilis syphilis, genital ulcers may appear in the phase I and II. Syphilis surface ulcers can occur. Syphilis infection after 2 to 4 weeks after the incubation period, in the spirochetes invade the local people when it first emerged that the chancre of syphilis lesions, characterized by a red inflammatory sclerosis painless, round, diameter of 1 ~ 2cm, the surface of shallow ulcers, the edge of neat peripheral uplift, sore face smooth, showing dark red, the surface of serous purulent discharge. Ulcers are mostly single, are located at the labia minora and labia lace can also be found in the clitoris, urethra, or cervix.
② chancroid: ulcers often as multiple, female primary ulcer average of 4 ~ 5, and ulcers can be self-cultivation, can also form in clusters around a small ulcer. Ulcers, generally by 1 ~ 2 months recovery. Involving the Department of its initial emergence of small inflammatory papules, surrounded by flush. 1 ~ 2 days into a pustule, formed after the erosion, ulceration, followed by expansion of the formation of ulcers, ulcers form sizes, diameter 1 ~ 20mm, edges rough and showed slope-like realm of clear, surrounded by flush around. Basal soft and deep, covered with gray or yellow necrotic purulent secretions, removing dirty purulent secretions that reveal granuloma-like basement, there is tenderness, easy bleeding.
③ venereal lymphogranuloma began as a single papule and herpes, blisters, or pustules, no pain, no infiltration then erosion or ulceration into shallow ulcers, ulcers occur in the vestibular Department, labia minora, vaginal and urinary tract around the mouth, etc. Department. Lesion morphology rules, the edge of a flat, superficial, after a few days to a half months after the self-limiting, without leaving any scars.
2. Chronic genital ulcer
(1) TB: genital tuberculosis rare, even secondary to severe lung, gastrointestinal tract, internal reproductive organs, peritoneum, or bone tuberculosis. Predilection on the labia or vestibular mucosa, lesions developed slowly. 'll Always be a beginning of the limitations of small nodules, ulceration soon wear thin as the edge of soft-dug shallow ulcers. Irregularly shaped ulcers, basal rugged, covered with cheese-like structure. Painless lesions, but subject to urine stimulation or may have pain after the friction. Prolonged unhealed ulcer and can be extended to the surrounding.
(2) Cancer: vulva cancer at an early stage can be expressed as papules, nodules or small ulcers. Multiple lesions are located at the labia, the clitoris and a joint, etc., with or without white lesions of vulva. Cancer, ulcers and tuberculosis ulcer naked eye is difficult to identify, to be done to biopsy diagnosis.
In patients with acute genital ulcers should be careful to check that the body skin, eyes, oral mucosa, etc. whether the lesion. The time of diagnosis must be clear ulcer size, number, shape, substrate, it is sometimes superficial ulcers covered with a number of secretions easily missed. Therefore, careful investigation should be carefully body secretions smear culture, serology or histological diagnosis of pathology helps.
1. Acute genital ulcers