MEDIX, God. 22 Br. 123  •  Pregledni članak  •  Dermatovenerologija HR ENG

Etiologija, diferencijalna dijagnoza i liječenje ulceracija u anogenitalnoj regijiThe etiology, differential diagnosis and treatment of anogenital ulcerations

Ana Križanović, Suzana Ljubojević Hadžavdić, Mihael Skerlev

Prilikom postavljanja dijagnoze u bolesnika s ulceracijom u anogenitalnoj regiji liječnici se često susreću s problemima u razlikovanju i prepoznavanju pojedinih stanja i uzroka ulceracija. Iako su genitalni herpes i sifilis najčešći uzroci ulceracija u anogenitalnoj regiji, uzroci mogu biti i mnoge druge spolno prenosive bolesti, kao što su: ulcus molle (chancroid), lymphogranuloma venerum, granuloma venerum (donovanosis, granuloma inguinale), infekcija humanim papiloma virusom (HPV), molluscum contagiosum i skabijes. Ulceracije u anogenitalnoj regiji ponekad mogu biti posljedica bolesti koje se ne prenose spolnim putem, od kojih su neke infektivne etiologije, a mnoge su posljedica neinfektivnog uzroka. Detaljna anamneza i klinički pregled smanjuju broj bolesti koje ulaze u diferencijalnu dijagnozu, ali potrebno je i laboratorijsko testiranje na najčešće patogene. Ponekad tek biopsija lezija i patohistološka analiza dovode do konačne dijagnoze. Zadaća je liječnika utvrditi uzrok anogenitalnih ulceracija te postaviti ispravnu dijagnozu kako bi mogao ordinirati ispravnu terapiju i smanjiti rizik za prijenos bolesti.

Ključne riječi:
genitalne ulceracije; spolno prenosive bolesti; bolesti spolovila

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 22 Br. 123

Distinguishing and identifying certain conditions and causes of anogenital ulcerations are common challenges in diagnosing patients with anogenital ulcerations. Although the most common causes of anogenital ulcerations are genital herpes and syphilis, anogenital ulcerations may also be caused by other sexually transmitted diseases such as: ulcus molle (chancroid), lymphogranuloma inguinale, granuloma venerum (donovanosis), human papilloma virus (HPV) infection, scabies and molluscum contagiosum. Ulcerations in the anogenital area can sometimes be the result of many genital diseases of infectious etiology, but many are the result of non-infectious causes. Detailed medical history and clinical examination reduce the number of diseases that are included in the differential diagnosis, but a laboratory testing on the most common pathogens is necessary. Sometimes only a lesion biopsy and histopathological analysis lead to the final diagnosis. The task of the doctor is to determine the cause of anogenital ulcers, and make an accurate diagnosis in order to document the administered therapy and reduce the risk of disease transmission. Often, only biopsy and histopathological analysis can lead to the correct diagnosis. The challenge for the clinician is to determine the cause of the anogenital ulcerations in order to apply appropriate therapy and to decrease the risk of transmission to others.

Key words:
genital diseases; genital ulcers; sexually transmitted infections