Genital Lesions

HISTORY:

Genital lesions for ‍ ‍hoursdays

Location: ‍pubispenisscrotumvulvavaginaperineumanus

‍pain

‍blisters

‍burning

‍itching

‍tingling

‍dysuria

‍vaginal discharge, ‍clear, ‍thin

‍fishy smell

‍urethral discharge

‍swollen lymph nodes in the groin

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍headache

‍muscle aches

Treatments tried: ‍none, ‍effectiveineffective



HPV vaccination status: ‍up-to-dateincompleteunvaccinated



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Pelvic: vulva ‍normal, vagina ‍normal, cervix ‍normal, uterus ‍normal, adnexa ‍normal, ‍no cervical motion tenderness

Genital: ‍normal, testicles ‍normal, penis ‍normal

Skin: ‍no rash



ASSESSMENT:

‍Genital rash ‍likelysuspectedpossible

DDx: ‍



PLAN:

- STI testing for chlamydia and gonorrhea

- HSV swab

- Blood work: ‍HIV, ‍syphilis, ‍hepatitis B, ‍hepatitis C

- HPV testing

- Biopsy

- ‍Topical treatments

- ‍Physical treatments

- ‍Intralesional treatments

- ‍Antivirals

- Use of condoms until lesions are completely treated (but may still be transmitted)

- Counseling on safe sex practices and disclosure to partners

- ‍HPV vaccine

- Referral to dermatologist

- Referral to gynecologist

- Referral to urologist

- Follow-up in ‍ ‍weeksmonths

- Return if lesions do not resolve or if new lesions develop