Appearance of chancre

Syphilitic chancre is the main manifestation of primary syphilis. It is a painless inflammatory medium caused by Treponema pallidum invading the skin and mucous membranes. It is more common in the reproductive organs. In men, it mainly occurs in the coronal sulcus, glans penis, foreskin is too long and frenulum of the penis; in women, it is common in the labia majora and minora, frenulum of the labia, perineum and cervix. Those occurring outside the genitals can be seen clinically, but are very rare.

What does a chancre look like?

Chancroid is a genital tract infection caused by Treponema pallidum and is a skin manifestation of primary syphilis. It mainly occurs in the area of ​​male and female genitals. Clinically, it manifests as painless inflammatory papules on the skin. The papules gradually expand and form lumps. Then the surface becomes necrotic and ulcerated, forming a coin-sized painless ulcer surface with serous secretions on the surface. The base of the ulcer surface is flesh red and has a cartilage-like texture to the touch, and contains a large number of Treponema pallidum.

What symptoms are easily confused with chancre?

Blood pressure genital herpes: It starts as a slightly convex erythema, and after 1 or 2 days, clustered small vesicles will develop, which are active and itchy, not hard, and can disappear after 1-2 weeks, but it is easy to relapse. The tissue was modeled as herpes simplex virus infection, and Tzank acid-fast staining was positive. PCR test for herpes virus infection DNA was positive.

Blood chancre-like pyoderma: The pathogen is Staphylococcus aureus or Streptococcus infection. The shape of the lesions is similar to that of chancre, but without the typical cartilage-like intensity, no dark red infiltration around them, no history of unclean sexual life, and the Treponema pallidum test was negative. The peripheral lymph nodes may swell, but they disappear during the recovery period of the skin lesions.

Supplementary information: Chancroid: It is also a sexually transmitted disease. It is caused by Haemophilus Duery if there is a history of sexual activity. The critical period is short (3-4 days), the disease onset is acute, the inflammation is obvious, the pain is tender, the skin lesions are often multiple, and there is purulent secretion on the surface. Haemophilus ducreyi can be detected, and the syphilis blood cell test is negative.

Weight-bearing tuberculous ulcers: also common in male genitalia, glans penis. The skin lesions are also independent shallow circular ulcers with scarring on the surface. The active symptoms are mild and tuberculosis bacteria can be detected. It is often accompanied by tuberculosis of internal organs.

Full-term Behcet's disease: It can cause ulcers on the vulva, and in women it can also be common in the vagina and cervix. The ulcers are deep and slightly itchy. The damage has no characteristics of chancre and is often followed by oral ulcers, eye damage (retinal cyclitis, anterior chamber abscess, etc.), calf erythema nodosum and walking arthritis, etc. The syphilis blood cell reaction is negative.

Subacute vulvar ulcer: The chancre type is similar to the hard chancre, but not as hard, with obvious inflammation and pain, and Streptococcus robustus can be found in the secretions.

Cartilage-fixed drug eruption: It can be seen on the inner leaf of the foreskin of the penis, the coronal sulcus, etc. It is a red rash, which may cause superficial erosion, active itching, no pain, no characteristics of chancre, a history of taking medicine, and a negative syphilis blood cell reaction.

The occult period of syphilis refers to the period from excitement to the first appearance of sores. After syphilis is stimulated, the Treponema pallidum invades the body through the incomplete parts of the skin or mucous membranes and forms a dense mass in the part. After a certain period of time, it turns into a hard chancre.

It spreads throughout the body through lymph nodes and blood. The site where the chancre comes out is the site where the syphilis spirochete invades. If the infection is transmitted through sexual intercourse, it will be transmitted through the genitals; if the infection is transmitted through kissing, it will be transmitted through the lips and mouth; if the infection is transmitted through the anus, it will be transmitted through the genitals.

If it is transmitted through sexual intercourse, it will come out in the duodenum; if it is transmitted through oral sex, it will come out in the throat; if medical staff are infected by accidental touch, it will come out in the fingers. Chancroids that appear in the foreskin are easy to detect; those that appear in the cervix are particularly difficult to detect.

Pay special attention when doing so.

Chancroid begins as a red macules or papules at the site of infection, which become firm and hard in 1-2 days, with erosion and rupture in the center.

Ulcers are copper-red in color, with a small amount of sticky secretions, round or ring-shaped, 1 cm in diameter, dry ulcer surface, slightly concave in the center, slightly higher around, the base material is hard like cartilage due to infiltration, no obvious pain, this is a typical hard ulcer

Chancroid. The secretions of chancre contain airborne Treponema pallidum, which is highly infectious. If chancre is not treated, it will disappear naturally after 3 to 8 weeks, usually leaving no scars.

One to two weeks after the onset of chancre, its proximal lymph nodes begin to swell, which is called lump lymphadenitis. Its refinement is several times more aggressive, but its size is not

1. The general diameter is 2 to 3 cm, the swelling is hard and obvious, the distribution is independent, there is no adhesion between each other and the surrounding tissues, and it can move. The surface is delicate, without pain or tenderness, and it does not become soft, infected or ulcerated. No surface skin

Inflammation, usually in the same direction as chancroid. When chancre appears in the superficial layer of the vagina or cervix, the swollen lymph nodes are in the pelvis and avoid being felt. Lymph node enlargement, regardless of treatment, disappears several weeks to several weeks later than chancre.

moon. This type of proximal lymphadenopathy is not only one of the typical symptoms of primary syphilis, but also because it disappears late, lymph node puncture fluid to detect Treponema pallidum can be used as a reliable method for diagnosing early syphilis when necessary.