Genital herpes

By Dr. Pascal Bafteh · last updated 09/2026

Diagnostics

• Method of choice: HSV PCR from a swab of the vesicle base or erosion — HSV DNA is available within hours and separates HSV-1 from HSV-2.
• Serology (gG-1/gG-2): only for special questions — assessment of partners (including in pregnancy), STI screening, a history of genital herpes without a current lesion. It cannot establish a primary infection, because the type-specific response takes months to build up.
• Less suitable: viral culture (about 48 h, sensitivity falls with the age of the lesion) and the Tzanck smear, which is simple but non-specific and yields neither the virus type nor the distinction from varicella zoster virus.

Differential diagnoses

• Secondary syphilis (lues II)
• Condylomata acuminata (genital warts)
• Zoon balanitis
• Lichen sclerosus
• Scabies
• Psoriasis vulgaris (plaque psoriasis)

Sources (selection)

1. Plewig G, French L, Ruzicka T, Kaufmann R, Hertl M (Hrsg). Braun-Falcos Dermatologie, Venerologie und Allergologie. 7. Aufl. Berlin: Springer; 2018. S. 104.

More sexually transmitted infections

• Secondary syphilis (lues II)

Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.