The following are the most important diseases or complications that may be contributed to by molle’s ulcer: Infectious and parasitic diseases (A00-B99). Bacterial superinfection of the ulcer (ulcer). Lymph node abscess – accumulation of pus in an encapsulated space. Skin – subcutaneous (L00-L99) Giant ulcer (ulcer) Symptoms and abnormal clinical and laboratory findings not elsewhere … Molle’s Ulcer: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin, mucous membranes, abdominal wall, and inguinal region (groin area) [painful lymphangitis (inflammation of regional lymph nodes)] Examination of the genital area: Male (urological examination) Inspection and palpation of … Molle’s Ulcer: Examination
Laboratory parameters of 1st order – obligatory laboratory tests. Culture of the pathogens from a smear of the ulcer. Special staining (Gram preparation), with which the pathogens become visible under the microscope [pathognomonic for H. ducreyi are fish-train-like structures]. Culture Nucleic acid amplification test (NAAT) – very high sensitivity and usually more sensitive than classical … Molle’s Ulcer: Test and Diagnosis
Therapeutic targets Elimination of the pathogens Avoidance of complications Partner management, i.e. infected partners, if any, must be located and treated (contacts must be traced for 10 days). Therapy recommendations Antibiosis (antibiotic therapy/first-line agent: azithromycin (macrolide) as a single dose; also ceftriaxone, if necessary); alternatively, erythromycin (macrolide antibiotic) or ciprofloxacin (antibiotic from the fluoroquinolone group). … Molle’s Ulcer: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Sonography (ultrasound examination) – to determine possible fistula formation in the diseased tissue; in men, for example, fistula formation from the urethra (urethra) to the glans penis (glans).
Lymph node abscesses (collections of pus in encapsulated cavities) must be surgically opened and drained. Phagedanic (ulcers with progressive spread by area or depth) and mutilating (“mutilating”) progressions may likewise require surgical intervention.
To prevent molle’s ulcer, attention must be paid to reducing risk factors. Behavioral risk factors Drug use including sharing of drug paraphernalia. Sexual transmission Promiscuity (sexual contact with relatively frequently changing different partners). Prostitution Men who have sex with men (MSM). Sexual contacts in the vacation country Unprotected coitus Sexual practices with high risk of … Molle’s Ulcer: Prevention
The following symptoms and complaints may indicate a molle ulcer: Leading symptoms Early symptoms are papules (nodule-like change on skin or mucosa) that change after a few days to pustules (pustules on skin or mucosa), which then turn into 1-3 cm painful ulcers (ulcers) with soft, purulent edges Painful lymphadenopathy (lymph node enlargement). The above … Molle’s Ulcer: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Ulcus molle is transmitted by the bacterium Haemophilus ducreyi mainly through sexual intercourse. The bacterium nests in small skin lesions, where papules then form that break open ulcerously and cause severe pain. Etiology (causes) Biographic causes Geographic factors – developing countries Behavioral causes Drug use including sharing of drug paraphernalia. Sexual … Molle’s Ulcer: Causes
Skin and subcutaneous (L00-L99). Folliculitis (hair follicle inflammation). Pyoderma (pustular rash) Infectious and parasitic diseases (A00-B99). Gonorrhea (gonorrhea) Granuloma inguinale (GI; synonyms: granuloma venereum, donovanosis) – tropical sexually transmitted infection (“STI”) caused by the bacterium Calmmatobacterium granulomatis, primarily associated with ulcers (genital ulcer disease, GUD) [to be excluded in later stages]. Herpes simplex genitalis – … Molle’s Ulcer: Or something else? Differential Diagnosis
Medical history (history of illness) represents an important component in the diagnosis of molle’s ulcer. Family history Social history Current anamnesis/systemic anamnesis (somatic and psychological complaints). Have you noticed any skin lesions such as pustules or painful ulcerations (boils) on the penis, labia, or around the anus? Have you noticed painful enlarged lymph nodes? How … Molle’s Ulcer: Medical History
General measures Partner management, i.e., infected partners, if any, must be located and treated (contacts must be traced for 10 days) Observance of general hygiene measures! Genital hygiene Once a day, the genital area should be washed with a pH neutral care product. Washing several times a day with soap, intimate lotion or disinfectant destroys … Molle’s Ulcer: Therapy
