RENAL AND GENITOURINARY
EMERGENCIES
TABLE 18.9. Sexually Transmitted Penile Ulcers
DISEASE ORGANISM CLINICAL PAINFUL?
Chancroid Haemophilus ducreyi Sharply demarcated ulcer with Yes
undermined edges; often multiple;
“Kissing lesions;” suppurative
inguinal nodes
Herpes Herpes simplex virus Grouped vesicles on red base Yes
form shallow ulcers.
Syphilis Treponema pallidum Painless, indurated ulcer; heals No
spontaneously
Lymphogranu- Chlamydia Transient, painless ulcer; followed No
loma venereum trachomatis by unilateral (mostly) inquinal
adenopathy which may
suppurate
Granuloma Calymmatobacterium Subcutaneous nodule(s), No
inguinale granulomatis becomes beefy red, highly
(donovanosis) vascular ulcer(s).
FIGURE 18.1. Chancroid penile ulcer. Painful sharply demarcated ulcer with undermined
edges. (See also color insert.)
(Courtesy of Professor Alfred Eichman, MD as reproduced, with permission, from Wolff K,
Johnson RA, Suurmond D. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology,
5th ed. New York: McGraw-Hill, 2005:926.)