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Penis and scrotum
Infectious disorders
Chancroid
Reviewers: Antonio Cubilla, M.D. and Alcides Chaux, M.D. (see Author/Reviewers page)
Revised: 18 February 2010, last major update February 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Sexually transmitted disease causing a painful genital ulcer and inguinal adenopathy; caused by Haemophilus ducreyi
Terminology
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● Dwarf chancroid: soft, painful, small ulcer
● Giant chancroid: may extend rapidly and be associated with ruptured inguinal abscess
● Phagedenic chancroid: may destroy external genitalia if superimposed Fusobacterium infection is present
● Do not confuse with chancre, a lesion typical of infection with syphilis
Epidemiology
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● Mainly in developing countries, particularly Africa, Asia and Latin America
● Associated with commercial sex workers
Etiology
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● Caused by Haemophilus ducreyi, a small gram-negative rod
Clinical features
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● Painful genital ulcer associated with tender suppurative inguinal adenopathy is suggestive
● Chancroid is a cofactor for HIV transmission
● Often culture negative because Haemophilus ducreyi is very fragile in transport
● Molecular techniques are useful for diagnosis
● Must rule out Treponema pallidum (serology or darkfield examination) and HSV, which may coexist
● References: Centers for Disease Control and Prevention
Treatment
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● Single oral dose of Azithromycin, or a single IM dose of Ceftriaxone or oral Erythromycin for seven days
Clinical images
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Ulcerative lesion Sligthly raised flat Ulcers Regional adenopathy
disc with central
ulceration
Micro description (Histopathology)
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● Zonation phenomenon at the ulcer base
● Upper layer is ulcer base with fibrin, neutrophils and necrosis
● Middle layer has granulation tissue, palisading blood vessels and thrombosis
● Deep layer has marked lymphoplasmacytic infiltrate
Micro images
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Gram stain Gentian Violet stain
Electron microscopy images
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Scanning electron microscopy
End of Penis and scrotum > Infectious disorders > Chancroid
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