HISTORY

Infections involving the mucous membranes have been documented since antiquity. For example, Hippocrates (460–377 B.C.) referred to condyloma and leprosy in his writings. Genital ulcers were first proposed to be transmitted sexually in the 1100s A.D. by Roger of Palermo. Syphilis, one of the most historically significant mucosal infections, was initially described during the late fifteenth century. Understanding of the pathogenesis of and recognizing the organisms implicated in these diseases blossomed during the latter half of the 1800s with the development of new microbiology and histopathology techniques, as well as the introduction of the Germ Theory paradigm.

The clinical presentation of certain diseases has evolved over time as a consequence of changing cultural norms. For example, whereas HSV-1 infection historically was limited to the oral mucosa and HSV-2 to the genitalia, both viral strains are identified frequently in both anatomic locations in recent times due to changing sexual practices. Moreover, disease epidemiology is continually changing as a result of medical advances. For example, syphilis has become much less common in the developed world after the development of penicillin. However, the recent increase in iatrogenic immunosuppression and other acquired immunodeficiency states has given rise to a modified set of diseases and disease presentations involving the mucosa. Finally, the ease of world travel has removed geographic boundaries that previously limited the spread of many infections, making it necessary for all practitioners – particularly primary care physicians, dermatologists, dentists, infectious disease specialists, gynecologists, and urologists – to be familiar with the spectrum of infectious diseases affecting the mucosa.