Chancroid or soft chancre is a sexually transmitted disease most commonly encountered in tropical countries. Outside of the tropics, it is rare but it is occasionally seen in travelers to or immigrants from endemic areas. Caused by the bacterium Haemophilus ducreyi chancroid gets its name from genital ulceration similar to the chancre seen in primary syphilis.
The bacterium enters the skin of the genital area via minor abrasion caused during sexual intercourse. Symptoms of the infection usually appear after an incubation period of 4-7 days but this period may fall in the range of 1-14 days.
The first symptom is a raised lump on the genitalia, which then forms a pustule before developing into a painful ulcer. Chancroid ulcers, which have a diameter ranging from 1/8 inch to 2 inches, have irregular but sharply defined borders, are soft and the base of the ulcer is covered with a gray or yellowish-gray material. If knocked the base of the ulcer is prone to bleeding. Untreated these ulcers may persist for weeks or even months.
In men it more commonly occurs in those who are uncircumcised. About half the men with chancroid have only one ulcer while women frequently have up to four. In women the ulcer often occur on the on the outer lips of the vagina or labia. Some times “kissing ulcers” occur where they occur on opposite surfaces of the labia. Other symptoms seen in women with chancroid are a vaginal discharge and pain during intercourse or urination. Fever is sometimes observed in patients with chancroid.
If the initial ulcer is not treated, about 50% of cases develop lymphadenopathy (swollen lymph nodes). This involves the inguinal (groin) lymph nodes. They start to swell 5-10 days after the appearance of the ulcer. The swelling nodes are hard and painful. They appear as a round swelling that may rupture. This type of swollen lymph node is frequently called a bubo.
Fortunately, once diagnosed chancroid responds to a number of antibiotics. Haemophilus ducreyi has proved sensitive to Azithromycin (Zithromax), Ceftriaxone (Rocephin), Erythromycin (EES, E-Mycin, Ery-Tab) and Ciprofloxacin (Cipro). Prompt treatment usually cures chancroid without leaving any scars on the genitalia.
Like many other sexually transmitted diseases, the use of condoms may prevent many cases of chancroid. Cases of chancroid frequently occur with other sexually transmitted diseases so test to diagnose such disease as HIV, Herpes, Syphilis, Gonorrhea and Chlamydia should be carried on persons presenting with chancroid.
New York State Dept of Health – Chancroid
Pub med Health