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Owrzodzenia genitalne w przebiegu chorób wenerycznych

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Choroby weneryczne takie jak m.in. kiła czy opryszczka są najczęstszą przyczyną występowania owrzodzeń genitalnych. Zmiany skórne w tym obszarze mogą się jednak pojawić także w przebiegu innych schorzeń przenoszonych drogą płciową.

Owrzodzenia genitalne są charakterystycznym objawem zakażenia chorobami przenoszonymi drogą płciową, takimi jak kiła lub opryszczka narządów płciowych. Mniej powszechne choroby zakaźne, w przebiegu których występują owrzodzenia genitaliów, to szankroid (szankier miękki, wrzód weneryczny) i donowanoza (ziarniniak pachwinowy).

Kiła

Owrzodzenie pierwotne jest charakterystycznym objawem zakażenia kiłą wczesną pierwszego okresu. Początkowo przybiera ono formę nacieku zapalnego, który nie powoduje dolegliwości bólowych. Szybko jednak przekształca się w owrzodzenie (najczęściej o okrągłym lub owalnym kształcie i gładkich brzegach, z dnem pokrytym surowiczą wydzieliną, o chrząstkowatej, twardej podstawie). Zmiany mogą także przyjmować nietypowe postaci, takie jak m.in. postać szczelinowata, zgorzelinowa, zapalna lub martwicza.

U mężczyzn owrzodzenie pierwotne występuje na członku, w kanale odbytu i odbytnicy. U kobiet objaw ten występuje najczęściej w obrębie szyjki macicy i warg sromowych. Do powikłań należą: stulejka, załupek, obrzęk stwardniały (u obydwu płci), wtórne zakażenie.

Opryszczka narządów płciowych

W przebiegu opryszczki na skórze i błonach śluzowych wykształcają się wypełnione surowiczą wydzieliną pęcherze, które powodują swędzenie. Następnie przekształcają się one w nadżerki i powierzchowne owrzodzenia. Zmiany występują w przypadku kobiet w obrębie warg sromowych, ścian pochwy, szyjki macicy, cewki moczowej i w okolicy okołoodbytniczej, natomiast u mężczyzn na napletku, żołędzi, a także w okolicy okołoodbytniczej i cewki moczowej. Objawom skórnym towarzyszy ból, pieczenie i ropna wydzielina.

Szankier miękki

Szankier miękki to przenoszona drogą płciową choroba zakaźna, która występuje przede wszystkim w krajach rozwijających się, w rejonie Afryki, Azji Południowo-Wschodniej oraz w basenie Morza Karaibskiego. W jej przebiegu w obrębie genitaliów pojawiają się krosty, które następnie przekształcają się w ropne owrzodzenia, powodujące nasilone dolegliwości bólowe. Zmiany wrzodowe mają miękkie i podminowane brzegi, towarzyszy im stan zapalny i sącząca się ropna wydzielina. W okolicy już istniejących owrzodzeń często pojawiają się liczne kolejne zmiany.

U mężczyzn zmiany wrzodowe najczęściej powstają na napletku, u kobiet natomiast na wargach sromowych większych. Powikłania wrzodu miękkiego mogą obejmować stulejkę, przetoki cewkowe, przetoki pochwowo-odbytnicze.

Ziarniniak pachwinowy

Ziarniniak pachwinowy, nazywany także donowanozą, to choroba zakaźna zaliczana do grupy schorzeń przenoszonych drogą płciową, występująca w rejonach tropikalnych i subtropikalnych. Ziarniniak pachwinowy występuje w czterech odmianach: wrzodziejącej, brodawkowej, śluzowej oraz mieszanej. Pierwszym objawem zakażenia są niebolesne pęcherze, które następnie przekształcają się w grudki i owrzodzenia. Dno owrzodzeń pokryte jest łatwo krwawiącą ziarniną, ich brzegi są ostro odgraniczone od skóry zdrowej. Wrzodziejące zmiany mogą pozostawiać blizny i doprowadzić do zwężenia cewki moczowej oraz odbytu. Jeżeli zmiany są zlokalizowane w okolicy pęcherza moczowego, może dojść do powstania przetoki pęcherzowo-pochwowej.

Źródła: https://www.cdc.gov/, https://www.medonet.pl/, https://medycynatropikalna.pl/

 

Przeczytaj także: W jaki sposób zespół Cushinga wpływa na gojenie ran?

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