Chancroid physical examination: Difference between revisions

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{{Chancroid}}
{{Chancroid}}
 
{{CMG}}; {{AE}} {{YD}} {{NRM}} {{SSK}}
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==Overview==
==Overview==


==Physical Examination==
==Physical Examination==
About half of infected men have only a single ulcer. Women frequently have four or more ulcers, with fewer symptoms. The ulcers appear in specific locations, such as the coronal sulcus of the uncircumcised glans penis in men, or the fourchette and labia minora in women.
===Vital Signs===
Typically normal
 
===Skin===
A patient may present with either of the following types of lesions on the genitals, depending on the stage of infection:<ref name="ChancroidUpToDate">Chancroid. UpToDate (September 25, 2015). http://www.uptodate.com/contents/chancroid#H3 Accessed January 19, 2016.</ref><ref name="Spinola2002">{{cite journal|last1=Spinola|first1=S. M.|title=Immunopathogenesis of Haemophilus ducreyi Infection (Chancroid)|journal=Infection and Immunity|volume=70|issue=4|year=2002|pages=1667–1676|issn=00199567|doi=10.1128/IAI.70.4.1667-1676.2002}}</ref>
*Erythematous [[papules]]
*[[Boil|Pustules]]
*[[Ulcers]]
 
Ulcer characteristics:<ref name="ChancroidWikipedia">Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.</ref>
*Ranges in size from 3 to 50 mm (1/8 to 2 inches) in diameter
*Painful
*Soft, nonindurated
*Irregular border
*Sharp margins
*Grey/yellow exudate
*Males typically have a single ulcer
*Females typically have multiplee ulcers


===Common locations in men (from most common to least common)===
===Common locations in males===
*[[Foreskin]] (prepuce) (most common)
*[[Foreskin]] (prepuce) (most common)
*Groove behind the head of the penis ([[coronal sulcus]])  
*Groove behind the head of the penis ([[coronal sulcus]])  
Line 17: Line 33:
*[[Scrotum]] (least common)
*[[Scrotum]] (least common)


===Common locations in women===
===Common locations in females===
In women the most common location for ulcers is the [[labia majora]]. "Kissing ulcers" may develop. These are ulcers that occur on opposing surfaces of the labia. Other areas such as the [[labia minora]], [[perineum|perineal]] area, and inner thighs may also be involved. The most common symptoms in women are pain with urination and pain with intercourse.
*[[labia majora]] (most common). "Kissing ulcers" may develop, defined as ulcers that occur on opposing surfaces of the labia.
*[[labia minora]]
*[[perineum|Perineal]] area
*Inner thighs (least common)


The initial ulcer may be mistaken as a "hard" [[chancre]], the typical sore of primary [[syphilis]], as opposed to the "soft chancre" of chancroid.
The initial ulcer may be mistaken as a "hard" [[chancre]], the typical sore of primary [[syphilis]], as opposed to the "soft chancre" of chancroid.

Revision as of 20:23, 21 January 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D. Nate Michalak, B.A. Serge Korjian M.D.

Overview

Physical Examination

Vital Signs

Typically normal

Skin

A patient may present with either of the following types of lesions on the genitals, depending on the stage of infection:[1][2]

Ulcer characteristics:[3]

  • Ranges in size from 3 to 50 mm (1/8 to 2 inches) in diameter
  • Painful
  • Soft, nonindurated
  • Irregular border
  • Sharp margins
  • Grey/yellow exudate
  • Males typically have a single ulcer
  • Females typically have multiplee ulcers

Common locations in males

Common locations in females

  • labia majora (most common). "Kissing ulcers" may develop, defined as ulcers that occur on opposing surfaces of the labia.
  • labia minora
  • Perineal area
  • Inner thighs (least common)

The initial ulcer may be mistaken as a "hard" chancre, the typical sore of primary syphilis, as opposed to the "soft chancre" of chancroid.

Approximately one third of the infected individuals will develop enlargements of the inguinal lymph nodes, the nodes located in the fold between the leg and the lower abdomen.

Half of those who develop swelling of the inguinal lymph nodes will progress to a point where the nodes rupture through the skin producing draining abscesses. The swollen lymph nodes and abscesses are often referred to as buboes.


Skin

Genital

References

  1. ↑ Chancroid. UpToDate (September 25, 2015). http://www.uptodate.com/contents/chancroid#H3 Accessed January 19, 2016.
  2. ↑ Spinola, S. M. (2002). "Immunopathogenesis of Haemophilus ducreyi Infection (Chancroid)". Infection and Immunity. 70 (4): 1667–1676. doi:10.1128/IAI.70.4.1667-1676.2002. ISSN 0019-9567.
  3. ↑ Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 "Dermatology Atlas".
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