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Ulcus molle – causes, symptoms, therapy

by Josephine Andrews
Published: Last Updated on 337 views

Ulcus molle (Ulcus, Latin = ulcer; molle = soft) is one of the sexually transmitted diseases. The sexually transmitted disease is relatively rare in Europe, but can be brought in by tourists. Synonyms for Ulcus molle are the terms soft chancre or chancroid. Read how to recognize the disease and how you can protect yourself from it.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

A57

Ulcus molle: description

Ulcus molle belongs to a group of diseases that are mainly transmitted through unprotected sexual intercourse. Doctors also speak of sexually transmitted diseases, STD for short – they are popularly referred to as sexually transmitted diseases. STDs include, for example , syphilis (hard chancre), gonorrhea, better known as gonorrhea , genital herpes and also HIV.

Although the soft chancre resembles the hard chancre in appearance, the course of the disease and the causative pathogens are completely different. It is therefore important that the two diseases are differentiated from one another.

Ulcus molle occurs mainly 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. However, not all women notice the infection, while men usually experience typical symptoms. Ulcers form on the genitals as obvious signs of illness. Ulcus molle does not heal on its own, but it can be treated well with antibiotics.

Ulcus molle: symptoms

Ulcus molle causes quite characteristic symptoms. The first signs of the disease appear about two to ten days after sexual contact with an infected partner. Initially, small, reddish papules form, which then turn into vesicles. From such a blister, an ulcer (ulcus) finally emerges. This is surrounded by a red, slightly raised hem. In the center of the ulcer there is a small gray-yellowish pit. At the beginning, the ulcers are only a few millimeters in diameter. If left untreated, however, they can grow to a diameter of up to two centimeters as they progress.

The ulcer feels soft when palpated (hence the Latin term molle = soft) and causes pain. Ulcus molle ulcers in men typically occur on the inside of the foreskin , on the edge of the glans and on the frenulum. The skin changes on the glans, on the shaft of the penis or on the pubic mound are somewhat less common.

In women, the ulcers appear mainly on the large and small labia and around the urethral orifice. The typical changes also occur in the internal genital organs such as the vaginal mucosa and the cervix. Since they usually do not cause pain in these areas, affected women usually do not notice the infection. The ulcerated skin changes can also serve as a portal of entry for other pathogens. Therefore, the soft chancre can pave the way for infections with HIV, genital herpes or syphilis.

Depending on the sexual practice, the sores of the soft chancre can also appear on the oral mucosa or in the anal area in rare cases.

If the Ulcus molle is not treated, the infection will continue to progress. The bacteria can then spread along the nearby lymphatics and cause inflammation there (Ulcus molle lymphangitis). In men, this can become noticeable through small abscesses, about the size of a cherry stone, in the area of ​​the base of the penis. The pathogens reach the inguinal lymph nodes about one to two weeks after the first signs of the disease. These are then painfully swollen and abscesses can also form here, which the doctor calls ulcus molle bubo. In extreme cases, such an abscess breaks open and the pus empties to the outside.

Ulcus molle: causes and risk factors

Ulcus molle is caused by the bacterium Haemophilus ducreyi. Infection almost always occurs through unprotected sex, that is, when condoms are not used during sex. Through direct skin contact, the bacteria can then penetrate the skin via the smallest injuries that are usually not visible to the naked eyeor penetrate the mucous membrane of the genitals. In contrast to circumcised men, the STD is more common in men with a preserved foreskin. Therefore, the presence of the foreskin is considered a risk factor for infection with Ulcus molle. Poor hygienic conditions and inadequate medical care in the distribution areas of the soft chancre contribute significantly to the spread of the disease. In addition, prostitution and sex tourism encourage the pathogen to spread to other regions of the world.

Ulcus molle: examinations and diagnosis

The externally visible changes to the skin and mucous membranes in Ulcus molle are similar to other sexually transmitted diseases such as syphilis or genital herpes. These must be distinguished from each other when diagnosing Ulcus molle. The doctor – usually a specialist in skin and venereal diseases – first inquires in a detailed discussion about how long the symptoms have existed and how they are expressed. Information about sexual habits is also helpful for the doctor – for example, if the person concerned has had unprotected sexual intercourse with partners whose state of health is uncertain.

This is followed by the physical examination. The doctor looks at the external genitalia and feels the lymph nodes in the groin region. In uncircumcised men, he pays particular attention to the area under the foreskin. In women, a gynecologist often makes the diagnosis of Ulcus molle. In addition to the outer genital region, he also examines the inside of the vagina and the cervix. If the typical ulcerated skin changes appear here, he takes a sample from the affected areas with a cotton swab (smear). The sample is then examined for bacteria in the laboratory. If the laboratory can prove the pathogen Haemophilus ducreyi, the diagnosis of Ulcus molle is certain.

Ulcus molle can also be the gateway for other sexually transmitted diseases. The doctor usually arranges for further tests to rule out additional infections such as syphilis, herpes simplex viruses or HIV.

Ulcus molle: therapy

The therapy for a Ulcus molle is relatively simple and usually quite uncomplicated. The pathogen, Haemophilus ducreyi, can usually be effectively combated with antibiotics. The drug of choice is the antibiotic ceftriaxone, which the doctor administers once by injection into the muscles. Alternatively, antibiotics such as azithromycin, ciprofloxacin or erythromycin are available in tablet form. However, the pathogen is more often resistant to older antibiotics. If a lymph node abscess has formed as a result of the infection, the doctor may need to surgically open it to drain the pus. In order to prevent re-infection, the affected partner must be treated in any case. It is also advisable to refrain from sexual contact until the Ulcus molle has completely healed.

Ulcus molle: prevention

It is relatively easy to protect yourself from sexually transmitted diseases such as Ulcus molle . Always use condoms when having sex with people whose health you are unsure of. Use the condoms consistently, that is before the beginning of the first sexual contact, until its end and for any sexual practice. If you have been diagnosed with an infection, be sure to inform your partner or anyone you have had sex with in the past few weeks.

Ulcus molle: course of the disease and prognosis

Ulcus molle usually has a good prognosis, since treatment is usually relatively easy. Without therapy, however, the disease can progress further and complications such as lymph node abscesses are possible. In addition, untreated people are at risk of infecting other sexual partners. An existing infection with Haemophilus ducreyi also increases the risk of becoming infected with other sexually transmitted diseases such as HIV.

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