GENITAL SKIN CHANGES IN SEXUALLY-TRANSMITTED DISEASES

When diseases of the genital skin are treated with topically applied drugs, it must be borne in mind that resorption through the genital skin is facilitated compared with other skin regions, so that toxic reactions can result even with low doses, and that it is not permissible to prescribe antibiotic treatment on the suspicion of ulcers without skilful diagnosis, because a primary syphilis might be overlooked in this way. Important diseases of the genital skin are: Condylomata acuminata. The prevalence has increased in recent years, to the point where genital warts are now one of the commonest sexually transmitted diseases. As they are contagious and involve the risk of malignant transformation, treatment is necessary in every case. Herpes genitalis. The typical blisters occur on the glans penis or the labia minora. At the time of presentation the physician often observes only excoriations and crusts. Herpes genitalis recidivans is particularly problematic, the only effective treatment being long-term acyclovir. Lymphopathia venerea is caused by Chlamydia trachomatis and is rare in central Europe. Treatment with quinolones is effective. Molluca contagiosa is a group of self-limiting viral diseases that occur in children; they are harmless in themselves, but sexual abuse should be considered. Parasitic diseases are caused by Phthirius pubis and Sarcoptes scabiei. The main symptom is severe itching. The diseases can be easily treated with suitable insecticides. Syphilis. The first sign of the disease is chancre, which can be described as a flat, indurated, nontender ulceration. It is difficult to identify the pathogen concerned, but in most cases the specific antibody reaction in serum is already measurable at the time of the occuring chancre. Treatment with penicillin is sufficient to avoid later stages. Chancroid is a rare bacterial disease in central Europe, which can be treated with quinolones.