How to determine if it is a chancre
Sep 25, 2024
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
In general, patients with chancres can be diagnosed through observation of skin symptoms, lymph node examination, review of contact history, serological testing, and dark-field microscopy. It is recommended to seek medical attention promptly, identify the underlying cause, and receive symptomatic treatment under the guidance of a qualified physician. Good hygiene practices should be maintained in daily life, and sexual contact should be avoided as much as possible.
Under normal circumstances, patients with hard chancres can determine their condition through observation of skin symptoms, lymph node examination, history review, serological testing, and dark-field microscopy. It is recommended to seek medical attention promptly, identify the underlying cause, and receive symptomatic treatment under the guidance of a qualified physician. Specific analyses are as follows:
1. Observation of Skin Symptoms
Hard chancre primarily manifests as damage to the skin and mucous membranes, possibly appearing as round, dish-shaped ulcers in areas such as the genitals, oral cavity, or anus. The ulcers typically measure 1–2 cm in diameter, have well-defined, raised edges resembling a levee, feel firm like cartilage upon palpation, and are usually painless or non-tender.
2. Lymph Node Examination
Patients with hard chancres often present with inguinal lymphadenopathy, though the swelling is typically not painful.
3. Contact History Review
Patients should recall whether they have had unprotected sexual intercourse or whether their spouse or sexual partner has syphilis, as hard chancre is primarily caused by infection with *Treponema pallidum*. A history of unsafe sexual contact is the main route of transmission for hard chancre.
4. Serological Testing
Under medical guidance, patients may undergo non-treponemal antigen serological tests and treponemal antigen serological tests to detect the presence of syphilis-specific antibodies.
5. Dark-Field Microscopy
Following medical advice, patients may provide a small sample of ulcer discharge for dark-field microscopy to check for the presence of *Treponema pallidum*. Typical spirochetes appear white and luminous, with dense and evenly spaced coils.
Patients should follow their doctor's recommendations regarding treatment with medications such as benzathine penicillin for injection, procaine penicillin for injection, or ceftriaxone sodium for injection. Maintaining good hygiene practices and minimizing sexual contact are also advised during treatment.
