Sexually Transmitted Viral Infections
Viral STIs are characterized by their latency, potential for recurrence, and association with cutaneous and mucosal lesions. Recognizing the morphology of these lesions is key to rapid clinical diagnosis.
Key Viral STIs
| Infection | Primary Clinical Finding | Key Distinguishing Feature |
|---|---|---|
| Herpes Simplex (HSV) | Grouped vesicles on an erythematous base | “Dewdrop on a rose petal”; painful. |
| HPV (Condylomata Acuminata) | Wart-like, cauliflower-shaped lesions | Associated with oncogenic types (16, 18). |
| Molluscum Contagiosum | Umbilicated, pearly papules | Poxvirus; common in children/immunocompromised. |
Clinical Pearls
- HSV Diagnosis: Tzanck smear shows multinucleated giant cells; the Gold standard is PCR.
- HPV Screening: Acetowhitening test (application of 5% acetic acid) highlights subclinical genital warts.
- Molluscum Contagiosum: If seen in adults in a generalized or sexually distributed pattern, consider testing for HIV/immunodeficiency.
High-Yield Exam Pearl:
- HSV Latency: Resides in the Sacral Ganglia for genital herpes, vs. the Trigeminal ganglia for oral herpes.
- HPV Strains: HPV 6 & 11 are the most common causes of genital warts (low oncogenic risk); HPV 16 & 18 are high-risk (cervical/anal cancer).