Genital herpes has a unique clinical presentation that includes easily recognizable clusters of small blisters, vesicles, and ulcers, so most physicians consider genital herpes to be extremely easy to diagnose. However, these typical symptoms of genital herpes are not common in clinical practice. Each episode of genital herpes may be completely asymptomatic or may present only as erythema, tiny fissures, skin peeling, skin abrasions, very mild vesicles, hard nodules, folliculitis, or itching. The site of genital herpes is also not necessarily limited to the genitals and may appear anywhere below the waist, including the buttocks, lower back, thighs, and perianal area. Genital herpes has only 20% of identifiable symptoms, 20% of those completely asymptomatic, and up to 60% of those with unidentified symptoms, so the disease is clinically underdiagnosed and misdiagnosed quite severely.