Chancroid

Chancroid (ulcus molle, soft ulcer) is a sexually transmitted disease. It affects the anogenital region. It is virtually absent in Europe but is the most common genital ulcer disease in Africa.

Etiology
The causative agent of the disease is Haemophilus ducreyi (G-stick, partially anaerobic).

Clinical picture
The incubation period is 3-7 days, then a papule with an erythematous border appears. It rapidly progresses to a pustule and soft ulcer, which is very painful, 1 mm-2 cm in size, and has rolled and undermined margins. It can be both solitary and multiple. Within two weeks, painful confluent lymphadenitis (bubo) with erythema on the surface develops. It may perforate, then fistulas with hemorrhagic exudate form.

Ulcus mixtum
Ulcus mixtum means the simultaneous occurrence of ulcus molle (chancroid, soft ulcer) and Treponema pallidum, where a transition to syphilitic symptomatology occurs.

Histopathological picture
Diagnosis is made by culture on blood agar, and chains of microorganisms are visible microscopically on a sample taken from the base of the ulcer.

Differential diagnosis
An ulcer should be differentiated from a hard painless ulcer in syphilis. It should also be differentiated from Herpes simplex, etc.

Therapy
Treatment with antibiotics (azithromycin, erythromycin, cefriaxone, ciprofloxacin).

Course and prognosis
If the disease is not treated, the ulceration progresses and may bleed or necrotize. Anogenital deformities develop.

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