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Multiple primary penile chancre: A re-emphasize.

Kalasapura RR, Yadav DK, Jain SK - Indian J Sex Transm Dis (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and VD, GMC, Kota, Rajasthan, India.

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Primary syphilis most often manifests as a solitary, painless chancre that develops at the site of infection within an average of 3 weeks after exposure to T. pallidum... Primary syphilis is most often associated with a single, painless chancre, although it can manifest in other ways (i.e., multiple chancres, painful papules or ulcers, or no lesions)... A diagnosis of multiple primary chancres was done and the patient was treated with a single intramuscular injection of benzathine penicillin 2.4 million units... On follow-up visit at day 7, lesions were healing reconfirming the diagnosis [Figure 2]... Most of the studies showing a constant or a rising prevalence of syphilis have shown an actual increase in the secondary stage of presentation... Solitary lesions are often thought to be typical, but multiple lesions frequently occur... Atypical clinical features like multiple non-indurated tender chancres and ulcers with irregular and slightly undermined margins, and unilateral lymphadenitis are also seen... Our patient presented with multiple chancres with atypical morphology, among them one was indurated and others were non-indurated... Furthermore seen was unilateral lymphadenitis... According to Koranne et al. out of 36 untreated primary chancre case four patients with primary syphilis had multiple chancres; two with two ulcers, one with three ulcers and one had four ulcers, three cases had only unilateral lymphadenitis... Lesions that can be confused with the chancre of primary syphilis include herpes simplex virus infection, chancroid, fixed drug eruption, lymphogranuloma venereum, granuloma inguinale (donovanosis), traumatic ulcer, furuncle (boil), and aphthous ulcer... In conclusion, multiple primary chancre with atypical manifestation as in our case appears to be rare we have to reconsider every case of multiple genital lesion to rule out syphilis.

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All chancre in healing phase after 7 days of follow-up
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Figure 2: All chancre in healing phase after 7 days of follow-up

Mentions: Gram stain of the tissue scraping from the base of ulcer was negative for Haemophilus ducreii and Neisseria gonorrhea. Dark ground microscopic examination revealed refractile T. pallidum only from newer lesion. Venereal Disease Research Laboratory titer was reactive up to 1:32 dilution. Bacterial culture of the tissue sample was negative. A diagnosis of multiple primary chancres was done and the patient was treated with a single intramuscular injection of benzathine penicillin 2.4 million units. On follow-up visit at day 7, lesions were healing reconfirming the diagnosis [Figure 2].


Multiple primary penile chancre: A re-emphasize.

Kalasapura RR, Yadav DK, Jain SK - Indian J Sex Transm Dis (2014)

All chancre in healing phase after 7 days of follow-up
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4066608&req=5

Figure 2: All chancre in healing phase after 7 days of follow-up
Mentions: Gram stain of the tissue scraping from the base of ulcer was negative for Haemophilus ducreii and Neisseria gonorrhea. Dark ground microscopic examination revealed refractile T. pallidum only from newer lesion. Venereal Disease Research Laboratory titer was reactive up to 1:32 dilution. Bacterial culture of the tissue sample was negative. A diagnosis of multiple primary chancres was done and the patient was treated with a single intramuscular injection of benzathine penicillin 2.4 million units. On follow-up visit at day 7, lesions were healing reconfirming the diagnosis [Figure 2].

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and VD, GMC, Kota, Rajasthan, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Primary syphilis most often manifests as a solitary, painless chancre that develops at the site of infection within an average of 3 weeks after exposure to T. pallidum... Primary syphilis is most often associated with a single, painless chancre, although it can manifest in other ways (i.e., multiple chancres, painful papules or ulcers, or no lesions)... A diagnosis of multiple primary chancres was done and the patient was treated with a single intramuscular injection of benzathine penicillin 2.4 million units... On follow-up visit at day 7, lesions were healing reconfirming the diagnosis [Figure 2]... Most of the studies showing a constant or a rising prevalence of syphilis have shown an actual increase in the secondary stage of presentation... Solitary lesions are often thought to be typical, but multiple lesions frequently occur... Atypical clinical features like multiple non-indurated tender chancres and ulcers with irregular and slightly undermined margins, and unilateral lymphadenitis are also seen... Our patient presented with multiple chancres with atypical morphology, among them one was indurated and others were non-indurated... Furthermore seen was unilateral lymphadenitis... According to Koranne et al. out of 36 untreated primary chancre case four patients with primary syphilis had multiple chancres; two with two ulcers, one with three ulcers and one had four ulcers, three cases had only unilateral lymphadenitis... Lesions that can be confused with the chancre of primary syphilis include herpes simplex virus infection, chancroid, fixed drug eruption, lymphogranuloma venereum, granuloma inguinale (donovanosis), traumatic ulcer, furuncle (boil), and aphthous ulcer... In conclusion, multiple primary chancre with atypical manifestation as in our case appears to be rare we have to reconsider every case of multiple genital lesion to rule out syphilis.

No MeSH data available.


Related in: MedlinePlus