WORKUP FOR A PENILE ULCER

By Gary M. White, MD

Chancroid of the Penis The tender, foul-smelling ulcer of chancroid.


Disease Clinical Findings
Herpes Genitalis Grouped erosions
Syphilis Firm, painless ulcer
Chancroid Tender, foul smelling ulcer
Granuloma Inguinale Beefy ulcer
Lymphogranuloma Venereum Transient ulcer, followed by enlarged nodes
Behcet's Disease Oral aphtha as well
Trauma History of trauma
Amebiasis, Leishmaniasis Recent travel outside of the country

Other

Foscarnet-Induced Ulcer

History

Sexual history? Past genital lesions? History of sexually transmitted disease?

Examination

Is there lymphadenopathy? Smell? Firm? Exudate?

Workup

Bacterial and viral culture.

Check RPR.

Treatment

Make your best guess as to diagnosis and treat with antibiotics. If wrong, worse thing is ulcer will stay. You can then reassess tests and retreat.

RegionalDerm

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