Vaginal ulcer

Introduction Vaginal ulcers are caused by bacteria or viruses in women's vaginal mucosa, or caused by syphilis, sexually transmitted lymphogranuloma and cancer. It is characterized by one or more ulcers in the vagina or genital area, accompanied by fever and pain. It is often secondary to inflammatory and malignant diseases of the vulva and vagina, and sometimes it can also be a reflection of systemic diseases in the vulva and vagina.

Cause

Vaginal ulcers are caused by inflammation of the vulva, such as non-specific vulvitis, herpes simplex virus infection, Behcet's disease, vulvar tuberculosis, syphilis, and sexually transmitted lymphogranuloma. In addition, about one-third of vulvar cancers appear as ulcers at an early stage. Some people think that vulvar ulcer is a special development stage of eye-mouth-genital syndrome.

Herpes simplex virus is the most common cause of vaginal ulcers. The disease is highly contagious, such as sexual intercourse, fetal teratogenicity and the carcinogenic effects of the patient itself, so it has attracted widespread attention.

Soft sputum is a disease transmitted by Ducrey Haemophilus through sexual intercourse, and it is also a more common sexually transmitted disease with ulcerative lesions.

an examination

Related inspection

Laboratory tests for fungal infections, vaginal secretions, cleanliness, blood routine

Laboratory inspection:

According to the history of the disease and the characteristics of the ulcer, if necessary, the secretion smear, culture, syphilis serological test, etc. to confirm the diagnosis.

Exfoliative cytology and enzyme-linked immunosorbent assay for genital herpes.

Pathogens can be found for smear examination of soft sputum secretions, secretion culture, and Ito-Reenstieno reaction.

Auxiliary examination of sexually transmitted lymphogranuloma: serum complement fixation test, diluted 16 to 64 times positive; smear to find intracellular inclusion bodies; chicken embryo and cell culture to isolate chlamydia.

Syphilis pathogen examination, dark field examination. In the first stage of syphilis, a small amount of serum exudate or lymphatic puncture can be placed on the slide, and the saline is added and observed under a dark field microscope. The judgment can be made according to the strong refractive power and movement pattern of the spiral.

Genetic diagnosis of infectious diseases: The use of polymerase chain reaction (PCR) to diagnose genital infections is fast, accurate and sensitive.

Soft chancre and histopathological examination: soft chancre and sometimes infected with syphilis, sexually transmitted lymphogranuloma, inguinal granuloma, vaginal herpes, etc., can detect the corresponding pathogenic microorganisms.

Syphilis serological examination: This type of examination is mainly to detect the presence or absence of anti-cardiac antibodies (reactive factors) in patients. Treponema antigen serum test to determine serum-specific antibodies.

Differential diagnosis

Genital herpes ulcers vary in size, and blisters are clustered. They are self-healing but often relapse. Eosinophilic inclusion bodies can be identified in exfoliated cells.

Ulcers are multiple, varying in size, clear in the realm, surrounded by redness, vaginal discharge is gray or yellow, patients have a history of unclean sexual behavior, multiple parts of the body, papules, pustules, ulcers are the characteristics of this disease. Secretion smear or histological pathology facilitates identification.

The leucorrhea of sexually transmitted lymphogranuloma is a yellow syrup. The ulcer is superficial, self-healing, and forms a fistula. Serological tests and smears can be found in intracellular inclusions. After the unclean sexual behavior, bilateral inguinal lymph nodes enlarge, soften, and ulcerate, which is a characteristic manifestation of this disease, and can be differentiated from other diseases.

The initial ulcer of syphilis is a single, shallow ulcer, painless, red inflammatory induration, round, 1 to 2 cm in diameter, with serous purulent discharge on the surface, often with systemic scattered rose rash, papule-like syphilis and pus The blister syphilis is often symmetrically distributed and is characteristic of this disease. Definitive diagnosis and differential diagnosis can be made by finding Treponema pallidum and serological examination in the exudate.

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