Cutaneous Sexually Transmitted Infections
STIs often present with cutaneous or mucosal manifestations. Recognizing these patterns is essential for screening and timely management.
Key Bacterial & Viral STIs
| Condition | Primary Clinical Finding |
|---|---|
| Primary Syphilis | Chancre: Painless, indurated ulcer with a clean base. |
| Secondary Syphilis | Maculopapular rash involving palms and soles; condylomata lata. |
| Chancroid | Painful, ragged ulcer with suppurative inguinal lymphadenopathy. |
| Genital Herpes (HSV) | Painful, grouped vesicles on an erythematous base. |
Diagnostic & Clinical Pearls
- Syphilis Screening: Always start with non-treponemal tests (RPR/VDRL) followed by specific treponemal confirmatory tests (FTA-ABS).
- Condylomata Lata vs. Acuminata: Lata (Secondary Syphilis) are flat, moist, and wart-like; Acuminata (HPV) are pointed, cauliflower-like genital warts.
High-Yield Exam Pearl:
- Painless vs. Painful Ulcers: Remember the mnemonic: Syphilis is Painless (Chancre), while Chancroid is Painful (Haemophilus ducreyi).
- Palms and Soles: Any rash involving the palms and soles in a sexually active patient should raise immediate suspicion for Secondary Syphilis, Rickettsia rickettsii, or Coxsackievirus.