Chancre

Introduction Hard chancre is the first-stage manifestation of syphilis in sexually transmitted diseases. It is often characterized by brownish red or oval superficial ulcers in the contact parts such as the genital anus. The bottom can touch the cartilage-like or coin-like feeling, and it is not painful, it is January. Self-healing left and right. The hard chancre has begun to appear as a red spot or pimples in the lesion, which becomes a small knot after 1 to 2 days and is hard, and then the center is smashed and ruptured, and it is reddish-brown with a small amount of sticky secretions, round or oval. Shape, about 1 cm in diameter, the ulcer surface is drought, the center is slightly sunken, the surrounding is slightly higher, the base is hard like cartilage due to infiltration, and there is no obvious pain. This is a typical hard squat. The secretion of hard chancre has a large amount of syphilis spirochete, which is highly contagious. If the hard sputum is not treated, it will naturally subside after 3 to 8 weeks, and generally does not leave a mark. However, patients with early syphilis (hard chancre) are the most contagious, but they are easier to diagnose and treat. If they can be diagnosed at an early stage and given rational treatment in time, they can complete the cure and avoid the purpose of spreading and harming society.

Cause

The cause of hard squatting:

1. Direct sexual contact: Sexual movement is its cumbersome infection route, and the vast majority of the genital infections.

2, including contact: In addition to sexual contact, people can also build infection by kissing, breastfeeding or containing daily necessities (such as clothing, cups, towels, razors, cigarette holders, etc.) that are contaminated with live spiral patients.

3, blood transfusion: mistakenly enter the blood of early syphilis patients.

4, fetal transmission: the spiral of blood in pregnant women with syphilis, can be transmitted to the fetus through the placenta.

an examination

Related inspection

Treponema pallidum antibody Treponema pallidum hemagglutination test Cerebrospinal fluid-specific Treponema pallidum antibody does not heat serum serotonin test cerebrospinal fluid routine test (CSF)

7 to 60 days after the infection of hard chancre, most patients with hard sputum as a single occurrence of genital, painless, itchy, round or oval, clear border ulcers, higher than the leather surface, sore surface is cleaner, there are success The infected person has more secretions. Touched cartilage hardness. It lasts for 4 to 6 weeks and can heal itself. Hard chancre has coexistence with secondary syphilis and must be differentiated from local ulcerative lesions such as soft chancre, genital herpes, and fixed drug eruptions.

The hard squat begins to produce a red spotted rash or pimples at the site of infection. It becomes a small knot after 1 to 2 days and is hard, and then the center is smashed and ruptured. It is reddish-brown with a small amount of sticky secretions, round or With a circular shape, the diameter is about 1 cm, the ulcer surface is arid, the center is slightly sunken, the periphery is slightly higher, the base is hard like cartilage due to infiltration, and there is no obvious pain. This is a typical hard squat. The secretion of hard sputum contains atmospheric syphilis spirochetes, which is highly contagious. If the hard sputum is not treated, it can be regressed after 3 to 8 weeks.

After 1 to 2 weeks of birth, the chancred lymph nodes become swollen and are inflamed lymphadenitis. Its ingenuity is a multitude of invasive, but the size is different, the ordinary diameter is 2 to 3 cm, the swelling is hard and clear, the distribution is isolated, and it does not stick to each other and to the surrounding production. The surface is delicate, no pain and tenderness, no softening, no infection, no ulceration. There is no inflammation on the surface of the skin, and the ordinary side is on the same side as the hard chin. When the hard chancre is born in the deep vaginal or cervix, the enlarged lymph nodes are in the pelvic cavity to prevent tactile sensation. Swollen lymph nodes, whether treated or not, are harder than a few weeks to months later. This swollen lymph node is not only one of the typical symptoms of primary syphilis, but also because it is late, the lymph node puncture is used to search for Treponema pallidum when necessary, which can be used as a reliable basis for the diagnosis of early syphilis.

Differential diagnosis

Differential diagnosis:

1. The first stage syphilis hard sputum should be differentiated from soft chancre, fixed drug rash, genital herpes and so on.

2. Primary syphilis lymphadenitis should be differentiated from lymphadenopathy caused by soft chancre and sexually ill lymphogranuloma.

3. The rash of secondary syphilis should be differentiated from pityriasis rosea, polymorphous erythema, tinea versicolor, psoriasis, and body lice. Flat wet warts should be differentiated from condyloma acuminata.

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