What is it about ?
A chancre is an ulcer that develops in the external genitalia in both men and women. These are sexually transmitted infections (STIs, venereal diseases), caused by bacterial infections. It is sexual contact with an infected partner that results in contamination.
There are several types of chancre. The most common is the hard chancre which occurs in syphilis. But there are also others. We discuss here 3 less frequent forms.
Chancroid (or chancre or Ducrey’s chancre)
Chancrelle is an STI caused by the bacteria Haemophilus ducreyi. The disease occurs mainly in the tropics and is often transmitted by people who prostitute themselves.
Two to 10 days after contamination, a painful mass develops, it suppurates and ruptures. A layer of dead (necrotic) tissue appears in its center and is surrounded by a raised red border. Men usually only have one lesion in the penis; on the other hand, women often have several lesions in the vagina. Anal sex or self-infection often results in lesions in the anus area. In one in two infected people, the glands in the groin swell, fill with pus over time, and form an abscess that can burst.
Confirmation of the diagnosis is based on culture and microscopic examination of pus or a piece of tissue.
The condition is treated with antibiotics. In case of insufficient results, a longer treatment may be necessary.
Lymphogranulomatosis venereal (LGV)
LGV is caused by certain types of the bacteria Chlamydia trachomatis. Two to 10% of all genital ulcers seen in Southeast Asia, Africa, Central America and the Caribbean are due to LGV. In Europe, the disease has emerged in recent years among the population of men who have sex with men. Unprotected anal sex is therefore a risk factor.
The most common symptom is inflammation around the anus. In its classic form, a small, painless ulcer develops on the penis or the wall of the vagina 10 to 14 days after infection and disappears after a few days. Two to 6 weeks later, a painful swelling of the lymph nodes, usually on one side, appears in the groin. An abscess can occur in a third of cases.
Other symptoms may be: fever with chills, generally feeling unwell, pain in muscles and joints. STIs can cause inflammation of the colon and rectum with abscess and fistula formation only years later. In this case, the symptoms may be the following: fever, pain, pain when having a bowel movement, itchy anal rash, and purulent or bloody diarrhea.
The diagnosis is usually based on clinical signs and a blood test.
The condition is treated with antibiotics for 3 weeks.
Inguinal granuloma (donovanosis)
Inguinal granuloma is caused by the bacteria Klebsiella granulomatis. The condition is rare in western regions. Sporadic cases are observed in India, Africa and the southwest Indian Ocean. Men who have sex with men are at greater risk of infection.
Genital nodules or ulcers develop 50 days after infection, on average. They get bigger and break after several days. They can develop into painless, red, “raw” looking ulcers that tend to bleed easily. The lesions can extend to the genital and anal regions, but also around these areas. Usually the lymph nodes are not swollen.
The analysis of a piece of tissue (biopsy) will confirm the diagnosis.
The treatment of first choice is to give antibiotics for 3 to 4 weeks. In the tropics, the disease is often diagnosed too late or goes untreated. It can therefore become chronic with, among other things, destruction of the mucous membrane, the development of other infections and death.
What about your sexual partners?
If you are diagnosed with an STI, your doctor will always examine you for possible other STIs (including syphilis and HIV) through a blood test and smear.
Sexual partners at risk of infection should always be informed in the following cases:
- in case of chancrelle: all sexual partners with whom the infected person has had sex within 10 days before the onset of symptoms;
- in case of lymphogranulomatosis venereal, all sexual partners of the last 6 months;
- in case of inguinal granuloma: all sexual partners with whom the infected person has had sex within 60 days before the onset of symptoms.
These sexual partners are advised to get tested. If indicated, they will be treated for safety.
The doctor will give you information on safer sex practices.
Want to know more?
- Modes of transmission of STIs – Depistage.be
- Protecting yourself against STIs – PPS – AIDS prevention platform
- What are STIs? (video) – LoveAttitude
Are you looking for more specialized help?
- Testing centers – PPS – AIDS prevention platform
- Health Promotion Among Men Who Have Sex With Men – Tie
- Medical services – IMT – Institute of Tropical Medicine
Source