08.08 ID

08.08 Infectious disease [PDF link]: Genitourinary infections / sexually-transmitted infections (STIs) – Bacterial vaginosis, Trichomonas vaginalis, Donovanosis, Genital warts, Chlamydia, Syphilis, Lymphogranuloma venereum, Genital herpes, Chancroid, Gonorrhoea, Ulcers in STIs

Internal links

• 08.06 for HIV

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Syphilis

• In addition to the buccal snail track ulcers (just google it), there are apparently ‘mowed meadow’ lesions you can get on the tongue in secondary syphilis!
  Angel JP. Plaques en Prairie Fauchée Tongue Lesions in Secondary Syphilis. N Engl J Med 2025;392. https://doi.org/10.1056/NEJMicm2411077.

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Crabs (or, more artfully, pediculosis pubis)

• Parasite Phthirus pubis.

• Transmitted via sexual contact, and less commonly through fomites.

• S/smx: Itch in affected area

  • Crabs specifically refers to pediculosis pubis, affecting the pubic and perianal areas. However, can also affect axillae and areas covered with chest hair.

  • Pediculosis ciliaris affects the eye lashes, and may be a/w conjunctivitis. May spread to eyebrows.

• Ix: Examination of affected areas – look for lice or nits (louse eggs) with microscope or dermatoscope if needed

• Mx: topical permethrin 1% cream – apply once, then one more time 7 days later

  • 2nd line options include malathion lotion or oral ivermectin

  • Treatment of pediculosis ciliaris requires manual removal ± use of petroleum ointment (2-4x/day for 10 days), alternatively oral ivermectin.

  • Sexual partners should also be checked and treated. Bedding/clothing should be washed in hot water and dried hot if possible.