Chancroid or Chancroidal Ulcers

Abstract

1532 cases with genital ulcers were investigated, of whom 610 presented with features suggestive of chancroid; classic, multiple lesions of chancroid were observed in 312, while its other variants, i.e. dwarf, giant and phagedaenic chancroid were also seen. In addition, 162 cases had a conspicuous morphology characterised by a single ulcer which was well-defined, soft, tender, non-indurated and had weakening edges. These were termed chancroidal ulcers. The latter had a longer incubation period of 8–11 days. Absence of lymphadenopathy was prominent in these cases. The male/female ratio was 27/1. Persons of low socio-economic status in the sexually vulnerable age-group were predominantly affected. The prepuce, coronal sulcus and glans penis were the common sites of affliction in males, while the labia minora was frequently involved in females. Due to the limited value of gram-stained smears for the detection of H. ducreyi and lack of good culture media, chancroid and chancroidal ulcers should be differentiated clinically.

Chancroid: contemporary appraisal

“…However, it has been known as soft sore, ulcer molle, chancre mon and soft chancre, among others. Chancroidal ulcer, 1 its intriguing variant, is a tender, nonindurated, single large ulcer caused by organisms other than H. ducreyi . Lymphadenopathy is conspicuous by its absence.…”

“…Lymphadenopathy is conspicuous by its absence. Better body resistance and indiscriminate use of antibiotics may be the incriminating factors in the exposition of the latter 1,4,15 …”

“…The disease affects both males and females, with the former outnumbering the latter. The male to female ratio was found to be 27 : 1 in India, signifying that women are asymptomatic carriers (reservoir) of the organism 1 …”

“…The incubation period for chancroid is short and varies between 3 and 5 days. However, chancroidal ulcers, its atypical variant, have a relatively long incubation period of 8–11 days 1 . Patients with HIV infection also present with an abnormally long incubation period.…”

“…Under the surface of the prepuce, prepucial orifice, shaft of the penis, glans penis, coronal sulcus and the frenum are the usual sites inmales, whereas in females the labia majora, fourchette and, less frequently, the labia minora and clitoris are affected. The extra‐genital sites, namely the thighs, anus, abdomen, hands, breasts, mouth and the feet 1,17,61 are infrequently affected.…”