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Primary Syphilis
Aka: Primary Syphilis, Primary Genital Syphilis, Chancre
- See Also
- Syphilis
- Sexually Transmitted Disease
- Primary Syphilis
- Secondary Syphilis
- Latent Syphilis
- Tertiary Syphilis
- Syphilitic Gumma
- Cardiovascular Syphilis
- Neurosyphilis
- Syphilis Testing
- Genital Ulcer
- Signs
- Solitary Chancre (hallmark of Primary Syphilis)
- Painless Papule ulcerates
- Indurated lesion with smooth base and firm border
- Chancre distribution
- Forms a Genital Ulcer in nearly all cases (may form on Cervix or perianally)
- May be difficult to visualize
- Men and women
- Carefully examine the perianal area
- Women
- Use a speculum and examine the vaginal mucosa
- Examine the introitus and between the labia
- Extragenital involvement (fingers, Oral Mucosa, nipples) in up to 5-7% of cases
- Chancre Course
- Chancre at 10 to 90 days after exposure (mean 21 days)
- Chancre heals within 3 to 6 weeks
- Nonsuppurative Regional Lymphadenopathy (uncommon)
- Follows Chancre development within 30 days and resolves over months
- Labs
- See Syphilis Testing
- Dark field exam of tissue sample may reveal Spirochetes
- Blood testing is often negative in Primary Syphilis
- Management
- See Syphilis
- References
- Green, Cohen, Billington (2016) Crit Dec Emerg Med 30(11): 4-10
- Mattel (2012) Am Fam Physician 86(5): 433-40 [PubMed]