Another Ulcer

Immune System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This young man has presented with a penile ulcer and unilateral inguinal lymphadenopathy soon after engaging in high risk sexual behavior. This should be considered to be due to a sexually transmitted infection (STI) until proven otherwise.\n\nGenital ulceration is a prominent feature of genital herpes (HSV) and syphilis, two of the most common STIs. Chancroid, lymphogranuloma venereum and granuloma inguinale may also present similarly, although these are comparatively rare.\n\nAs each of the above diseases causes a characteristic pattern of ulceration, a careful clinical examination is key to the diagnosis. This reveals the ulcer to be painful and shallow, with a ragged edge and a granulomatous base; and the lymphadenopathy to be unilateral an"}]}

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