Genital Lesions - Differential Diagnosis Algorithm

Elevated - Vesicles:

 • Herpes simplex

Elevated - Papules / Plaques - Infectious:

 • Molluscum contagiousum

 • Human papilloma virus warts (condyloma acuminata)

 • Secondary Syphilis (condyloma lata)

 • Reiter's syndrome (circinate balanitis)

Elevated - Papules / Plaques - Non-infectious - Inflammatory:

 • Lichen planus

 • Psoriasis

Elevated - Papules / Plaques - Non-infectious - Malignant:

 • Squamous cell carcinoma (can be in situ)

 • Melanoma

Depressed - Excoriations

 • Scabies

 • Pubic lice

Depressed - Erosions/Ulcers - Painful

 • Herpes simplex

 • Haemophilus ducreyi (chancroid)

 • Behcet's syndrome

 • Pemphigus vulgaris

 • Lichen Sclerosis

 • Erosive Lichen Planus

Depressed - Erosions/Ulcers - Painless

 • Primary syphilis (chancre)

 • Granuloma Inguinale

 • Lymphogranuloma venereum



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