man with pain in defecation, no gastrointestinal symptoms, clustered ulcers extending into anal canal. Diagnosis-

Ans. is 'c' i.e., Herpes genitalis Herpes genitalis is a sexually transmitted disease, characterized by appearance of multiple painful vesicles in clusteres in genital area which later on may ulcerate. These small ulcers may combine to form a large ulcer. First attack of this in infection may be associated with flu like symptoms but GIT symptoms are usually absent. Gonorrhea is characterized by acute anterior ahritis associated with thick yellow urethral discharge. Perianal ulceration is not a feature of gonorrhea. Although HIV can be considered in the differential diagnosis of Perianal ulcers, but is usually associated with GIT symptoms. Perianal ulceration is not a feature of CMV infection.