|
| Fig. 28.3 A typical presentation of primary syphilis demonstrating
two chancres. (Courtesy of William James, MD.) |
|
| Fig. 28.2 Typical Hunterian chancre of syphilis demonstrating
characteristic indurated border. |
The classic Hunterian chancre develops at the site
of inoculation as a painless ulcer with a firm,
indurated border (Fig. 28-2). The size may vary from
a few millimeters to several centimeters in diameter.
Associated unilateral or bilateral, painless, regional,
nonsuppurative lymphadenopathy develops in 50%
to 85% of patients approximately 1 week after the
appearance of the primary ulcer. It is important to
realize that up to 50% of all chancres are atypical.
Painful ulcers, multiple ulcers (Fig. 28-3),
secondarily infected ulcers, and nonindurated ulcers
are variations on the classic chancre.
Lee V, Kinghorn G: Syphilis: an update,
Clin Med 8:330–333,
2008.
