Ulcus molle: Information & Ulcus molle Specialists

Worldwide, there are approximately 7 million new cases of chancroid each year. This sexually transmitted disease occurs primarily in tropical regions

• Africa,
• Southeast Asia, and
• Latin America

. There, the causative agent, Haemophilus ducreyi, is particularly widespread.

In Africa, chancroid is the most common cause of genital ulcers in men. In Germany and other European countries, however, chancroid is relatively rare. It mostly affects travelers returning from the tropics who have had sexual intercourse with sex workers there.

The causative agent of chancroid is the bacterium Haemophilus ducreyi. This is a rod-shaped, Gram-negative bacterium of the family Pasteurellaceae. The bacterium is very sensitive to cold and dehydration. This explains its widespread prevalence in tropical countries.

In most cases, the chancroid pathogen is transmitted through sexual intercourse.

During sexual intercourse, the bacteria enter the tissue through tiny skin abrasions or the mucous membranes. There, they cause the soft ulcers that give chancroid its name.

In Germany and Europe, the bacterium that causes soft chancre is relatively rare.

The first symptoms usually appear about 3 to 10 days after infection.

One or more painless nodules then form at the site where the bacteria entered the genital area. Over the following days, these develop into roundish-oval, thumbnail-sized, and very painful ulcers. These can reach a size of one to two centimeters.

These ulcers are soft and have an irregularly jagged, sharp edge as well as a purulent surface.

In men, these characteristic ulcers usually appear

• on the shaft of the penis,
• on the foreskin, and
• on the glans

.

Women often carry the Ulcus molle pathogen without developing symptoms. If the ulceration typical of Ulcus molle occurs, it is usually

• the vaginal opening,
• the labia, and
• the vestibule of the vagina

are affected.

If left untreated, the bacterial pathogens spread further throughout the body. This can lead to painful, inflamed swollen lymph nodes in the groin area. These are also known as buboes.

If these swollen lymph nodes remain untreated, they may become abscessed as the condition progresses and, in some cases, rupture through the skin.

Chancroid is diagnosed based on its characteristic symptoms and by detecting the causative agent.

The examination is usually performed by a gynecologist or urologist. If a patient exhibits the characteristic symptoms, the doctor can usually diagnose chancroid.

In addition, the doctor usually takes a swab from an ulcer. In the laboratory, the tissue sample is examined for the pathogen responsible for chancroid. The chancroid pathogen is usually already visible under the microscope.

To further confirm the diagnosis, a culture is then prepared to grow the bacteria. This is done because there is a risk of confusion with other diseases that have similar symptoms, such as

• syphilis or
• genital herpes.

Laboratory detection of the soft chancre pathogen therefore also serves to rule out other pathogens.

In cases of chancroid, the sexual partner must also be treated © Khunatorn | AdobeStock

Chancroid is usually treated with antibiotics that specifically target the bacterial pathogens. Erythromycin is a particularly common choice of antibiotic. The patient must take it daily for 7 days. The antibiotic ciprofloxacin is also effective; in this case, a single daily dose for three days is sufficient.

In addition, any broken sores should be cleaned regularly and kept dry.

Treatment for chancroid can only be successful if the affected person’s sexual partner is also treated. Otherwise, a cycle develops in which the partners repeatedly infect each other.

You must abstain from sexual intercourse until the condition has completely healed.

With early and consistent treatment of chancroid, the sores and the bacterial infection usually heal without complications. Painful lymph nodes do not develop in the first place.

However, even if treatment is started later, the prognosis for recovery is very good.