[Sexually transmitted infections of the anorectal region]

Sexually transmitted infections (STIs) are increasingly observed in men who have sex with men (MSM), which is associated with the success in the antiretroviral treatment of HIV infection. Additionally, in heterosexuals, anal intercourse is more prevalent than previously assumed. Thus, anorectal manifestations of STIs are not a rare condition.

This review will focus on the clinical picture, diagnosis and therapy of frequent STIs involving the anorectal region.

Due to localisation and frequent asymptomatic course, STIs in this region often pose diagnostic problems. Anorectal manifestations of STIs consist of tumorous masses, ulcers or proctitis and may be misdiagnosed as malignancy or inflammatory bowel disease. Herpes simplex and syphilis primarily show ulcerations and may involve the perianal region, whereas gonorrhoea and lymphogranuloma venereum mainly cause proctitic symptoms with exsudation. Because of commonly occurring coinfections a complete diagnostic workup concerning other STIs should be performed.