Brief overview
- Symptoms: Initially reddish papules, later vesicles, then painful ulcers, in men usually under the foreskin, in women on the labia, urethral area, vagina or cervix; inflammation of the lymph nodes, sometimes lymph node abscesses.
- Causes and risk factors: Infection with Haemophilus ducreyi bacterium, transmission through unprotected sexual contact.
- Examinations and diagnosis: smear from the changed area, pathogen detection in the laboratory
- Course of disease and prognosis: Complete cure with appropriate therapy.
- Prevention: Use of condoms (safer sex)
What is a molle ulcer?
Ulcus molle (also soft chancre or chancroid) belongs to the sexually transmitted diseases, or STDs for short – they are popularly known as venereal diseases. STDs include, for example, syphilis (hard chancre), gonorrhea, better known as “gonorrhea,” genital herpes, and also HIV.
Ulcus molle occurs predominantly in the countries of South America, Southeast Asia, and Africa. Occasionally, however, infections with the bacterial pathogen can also be observed in western industrialized countries. Men are about ten times more likely to be affected by the disease than women.
What are the symptoms of molle’s ulcer?
The ulcus molle causes quite characteristic symptoms. About two to ten days after sexual contact with an infected partner, the first signs of the disease appear:
- Small, reddish papules at the beginning
- Papules develop into vesicles
- At the site of the vesicles, an ulcer develops with a red, slightly raised seam and a grayish-yellow pit
The ulcer feels soft to the touch (hence the Latin term molle = soft) and causes pain. In men, the ulcers of the molle ulcer typically occur on the inside of the foreskin, on the glans rim and on the foreskin frenulum. Somewhat less frequently, the skin changes are found on the glans, on the shaft of the penis or on the mons pubis.
The ulcerated skin lesions also serve as an entry portal for other pathogens. Therefore, there is a risk that soft chancre may be a precursor for infections with HIV, genital herpes or syphilis.
Depending on the sexual practice, the ulcers of soft chancre also occur in rare cases on the oral mucosa or in the anal area.
About one to two weeks after the first signs of the disease, the pathogens reach the inguinal lymph nodes. These are then painfully swollen and abscesses sometimes form here as well, which the doctor calls ulcus molle bubo. In extreme cases, such an abscess breaks open and the pus empties outward.
What is the cause of a molle ulcer?
In contrast to circumcised men, STD occurs more frequently in men with preserved foreskin. Therefore, the presence of the foreskin is considered a risk factor for infection with ulcus molle.
How can a molle ulcer be recognized?
The externally visible changes in the skin and mucous membrane of a molle ulcer are similar to other venereal diseases such as syphilis or genital herpes. These must be differentiated from each other when diagnosing molle’s ulcer.
This is followed by a physical examination. The doctor examines the external genitalia and palpates the lymph nodes in the groin region. In uncircumcised men, he pays particular attention to the area under the foreskin.
The sample is then examined in the laboratory for bacteria. If the laboratory detects the pathogen Haemophilus ducreyi, the diagnosis of molle ulcer is confirmed.
The ulcus molle often also serves as a portal of entry for other STIs. Therefore, the doctor usually orders further tests to rule out additional infections, such as syphilis, herpes simplex viruses or HIV.
How can a molle ulcer be treated?
However, the pathogen is more often resistant to older antibiotics. If a lymph node abscess has formed in the course of the infection, the doctor may have to open it surgically to drain the pus. In order to prevent a new infection, it is necessary to treat the partner concerned in any case.
It is also advisable to refrain from sexual contact until the ulcus molle has healed completely.
Is a molle ulcer curable?
An existing infection with Haemophilus ducreyi also increases the risk of contracting other sexually transmitted diseases such as HIV.
How can a molle ulcer be prevented?
If you have been diagnosed with an infection, be sure to inform anyone you have had sex with in the past few weeks.
