The soft chancre (or chancrelle or canker of Ducrey ) is a Sexually transmitted disease (MST) due to the bacillus of Ducrey (or Haemophilus ducreyi ) characterized by a canker of inoculation ulcerated associated with Adénopathie S (swelling of a lymphatic Ganglion) sometimes suppurées.

Physiopathology

Haemophilus ducreyi is a Bactérie in the shape of stick, motionless, negative Gram, which is transmitted by sexual contact, put in obviousness for the first time by the Italian Augusto Ducrey in 1889. It is extremely contagious and does not get immunity (one can again contract the disease after having cured, at the time of a new contaminating contact). The women are the principal vectrices of the disease when they carry the bacterium, because symptomatology is moderate. At the man on the contrary, the canker is very painful, which allows a relatively early doctor visit and to limit the contaminations.

Epidemiology

The soft chancre is widespread in the tropical and subtropical countries , particularly at the prostitutes. In the industrialized countries, the Maladie can meet associated with others MST in the exposed populations.

Diagnosis

The disease appears after one period of incubation varying 12 midnight to 15 days (on average 5 days) by a small papule dew instead of penetration of the bacterium (in general on the rod). The lesion evolves quickly to an ulceration more or less extended, dew, painful, major, at the inflammatory edges very and Nets, of déchiquetté aspect. With the difference of the canker caused by the Syphilis, the bottom of the canker is not hardened.

The canker is also very pruriginous (it causes intense démangaisons), which actuates a car-infestation by scraping quickly (appearance of multiple cankers in all the genital area).

The adenopathies are later, appearing 2 to 3 weeks after the contact. They are often unilateral, and can evolve to ulceration with flow of pus to the Peau.

Complementary examinations

The identification of the bacterium can be made by microscopic examination of a Frottis of the canker, more rarely by puncture with the fine needle of an adenopathy. The coloring of Giemsa or that of Pappenheim makes it possible to identify the germ, apart from the frequent case of superinfection which can impose a histological examination after ganglionic Biopsie.

Complications

• Gangrène of the rod which can lead to the Amputation,
• Gangrène cutaneous wide,
• local Superinfection,
• Association with other MST (the cutaneous wound that the canker constitutes is a main door for the viruses and the bacteria.)

Treatment

The disease is benign in the large majority of the cases and tends to the spontaneous cure. However, the potential pain and complications make advise a treatment Antibiotique. The partners must be detected and treated. The search for other associated MST (in particular AIDS and Syphilis) must be systematic.

See too

• Syphilis

External bonds

• old teaching Moulding (wax) presenting the soft chancre (Collection of the mouldings of the Hospital Saint-Louis).

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Years 340 | Pulp of Bordeaux | Tears | Saint-Priest-the-sheet | Manzanares (Jose María Abellán Frauds)