“Soft chancre” is one of the four classic venereal diseases. However, it has been very rare in Europe for 100 years and occurs mainly in Africa, the Caribbean, and Asia. Triggers are bacteria of the strain Haemophilus ducreyi. Learn more about symptoms and therapy here.
Of microbes and people
Until the beginning of the last century, ulcus molle (or “chancroid”) was relatively common even in our latitudes. Today, it affects mainly tropical and subtropical regions and there predominantly socially lower-ranking groups. The germs are transmitted through small skin or mucous membrane injuries during unprotected sexual intercourse. Soft chancre occurs significantly more frequently in men than in women, and circumcised men are less likely to be infected. The likelihood of infection is increased in people who already have another STD.
Hard facts and dark numbers
Accurate disease figures are impossible to obtain primarily because of the difficulty of diagnosis, but also because of the often unrecognized nature of the disease. The World Health Organization estimates that there were 7 million new cases worldwide in 1995. In the USA, outbreaks have been recorded from time to time in larger cities in recent years; the incidence is estimated to be ten times rarer than that of syphilis. In Germany, fewer than 100 cases were diagnosed in 1991-99. Presumably, the true number of cases is much higher.
Symptoms and stages
As with many other venereal diseases, the name already describes part of the symptoms: typical are ulcers (“ulcus”) – developing rapidly from small nodules – that feel soft (“molle”) and bleed rapidly when touched. These extremely painful skin lesions with typically overhanging edges form a few days after infection at the site of entry of the pathogen, e.g. penis, labia or vagina.
After days to weeks, the nearby lymph nodes, e.g. in the groin, usually swell strongly on one side (“bubo”) and hurt. They can ulcerate and burst open.
In men, inflammation of the glans or narrowing of the foreskin may also occur. Sometimes the infection goes unnoticed. After weeks, the symptoms disappear; however, the pathogens remain in the body and can lead to re-infection.
Detection and therapy
Symptoms can lead to confusion with another ulcer-causing STD, such as syphilis or genital herpes. Laboratory diagnosis is difficult. It is made by microscopic detection of the causative agent from swabs taken from the ulcers or by culturing the germ. If clinical and laboratory findings are inconclusive, one of the other diseases may need to be ruled out.
Treatment is with antibiotics. Almost always, a single high-dose administration is sufficient, usually as an injection into the muscle. To relieve swollen lymph nodes, they can be punctured. Sexual intercourse should be avoided until complete healing.
To the point
- Ulcus molle is v.a. a disease occurring in the tropics and subtropics.
- Infection occurs through all sexual practices associated with mucosal contact.
- Protection is provided by condoms. The first sign are small, painful ulcers. A complete cure by means of antibiotics is possible.
- The sexual partners should be treated if necessary.
- You can always get infected again.
