In the latter, it is often a sexually transmitted disease, and appears in the genital area. It is due to a DNA-containing pox virus. The incubation period is usually two to seven weeks, with a range of one week to six months. The disease has a low incidence, about one case per 42 to 60 cases of gonorrhea, but is often associated with other STDs. Autoinoculation can occur, and so may produce additional lesions, often in a linear string.
Most patients are asymptomatic, but a few have pain, itching, and tenderness.
Diagnosis Diagnosis is usually clinical. Usually the apex is umbilicated, a useful diagnostic point. A cheesy, milky-white substance can be easily expressed from the lesions, made up of elementary bodies containing the virus and the husks of epidermal cells. This material can be stained by Pap, Wright, Giemsa, or Gram stain, to reveal the characteristic lesions. The lesions usually resolve spontaneously in about two months, without scarring.