Family Nurse Practitioner Exam

The differential diagnosis for genital ulceration includes all of the following except?

1. Syphilis

2. Genital herpes

3. Chancroid

4. Molluscum contagiosum

The correct answer is: Molluscum contagiosum

The choice of Molluscum contagiosum as the exception in the differential diagnosis for genital ulceration is based on the nature of the lesions it causes. Molluscum contagiosum typically presents as small, raised, pearly lesions with a dimpled center and is not characterized by ulceration. It is a viral infection caused by a poxvirus, often transmitted through skin-to-skin contact, and the lesions do not usually lead to the deeper tissue destruction that is seen in ulcerative conditions. In contrast, the other conditions listed, such as syphilis, genital herpes, and chancroid, are known to produce genital ulcers. Syphilis often presents with a chancre, a painless ulcer that marks the primary stage of the infection. Genital herpes is characterized by painful vesicular lesions that can rupture and form ulcers. Chancroid is associated with soft, painful ulcers that can be quite large and are caused by Haemophilus ducreyi. Thus, while all the other options represent causes of genital ulceration, Molluscum contagiosum does not fit within this category due to its distinct presentation of non-ulcerative lesions.