How are chancroid lesions characterized?

Updated: Aug 05, 2019
  • Author: Joseph Adrian L Buensalido, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

The lesion of chancroid is often termed as a soft chancre because it is not indurated, as opposed to the indurated syphilitic chancre. The lesion begins as erythematous tender papules that become pustular and later erode to form an extremely painful and deep ulcer with soft (in contrast to the chancre of syphilis) ragged margins.

The ulcer base is composed of easily friable granulation tissue that is usually covered with malodorous yellow-gray exudates.

Ulcers may be single or multiple, and as many as 10 ulcers have been reported on a single patient.

Men more commonly present with single ulcers, whereas women typically have multiple lesions. “Kissing ulcers” occur when one ulcer spreads the infection to the opposite skin surface. Kissing ulcers can form on the lips of the labia majora.

Individual ulcers vary in size from 1-20 mm, with 1-2 cm being the most common size.

In circumcised men, lesions are most commonly found on the coronal sulcus. In uncircumcised men, the lesions are commonly found on the prepuce. Lesions may be obscured by a painful phimosis in uncircumcised men.

In women, lesions are most commonly found on the fourchette, labia, vestibule, clitoris, cervix, and anus. Women may not have not external sores but may present with dysuria, dyspareunia, and vaginal or rectal discharge.

In both men and women, adjacent lesions may merge and form confluent lesions.

Superinfection of ulcers, especially fusospirochetal, may occur and cause deep, necrotic, and gangrenous ulcers. The infection rapidly spreads to subcutaneous and deeper tissues, leading to rapid destruction of the external genitalia, known as phagedenic chancroid.


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