0071643192.pdf

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.)