Summary about Disease
A chancre is a painless, open sore that typically develops at the site of a syphilis infection. It is the primary sign of syphilis and usually appears on the genitals, but can also occur on the mouth, lips, fingers, or other areas. Chancres are highly infectious. While the chancre itself will heal without treatment, the underlying syphilis infection will persist and progress to more serious stages if left untreated.
Symptoms
A single, painless, firm, round sore.
The sore is usually small (a few millimeters to a few centimeters in diameter).
The sore has a clean, smooth base.
Swollen lymph nodes in the area near the chancre may occur.
Location: Most commonly found on the genitals, but can also appear on the anus, mouth, lips, fingers, or other areas.
Causes
Caused by the bacterium Treponema pallidum*, which is the causative agent of syphilis.
The bacterium enters the body through small cuts or abrasions in the skin or mucous membranes during sexual contact with an infected person.
Medicine Used
Penicillin: Is the preferred treatment for all stages of syphilis, including the chancre stage. It's usually administered as an injection.
Alternatives for penicillin-allergic patients: Doxycycline, tetracycline, ceftriaxone, or azithromycin may be used, but their effectiveness may vary.
Is Communicable
Yes, extremely communicable. Chancres are highly infectious. The bacteria can be easily transmitted through direct contact with the open sore, usually during sexual activity (vaginal, anal, or oral sex).
Precautions
Abstinence: Avoid sexual contact with infected individuals.
Condoms: Use condoms correctly and consistently during sexual activity. However, condoms only protect areas they cover, so a chancre located on an uncovered area can still transmit the infection.
Avoid Sharing: Avoid sharing personal items (razors, toothbrushes) with someone who is infected.
Regular Testing: Get tested regularly for sexually transmitted infections (STIs), especially if you have multiple partners or engage in high-risk behaviors.
Partner Notification: If you are diagnosed with syphilis, inform your sexual partners so they can get tested and treated.
Avoid Touching: Avoid touching the chancre, if possible. If you do, wash your hands immediately and thoroughly with soap and water.
How long does an outbreak last?
The chancre typically lasts for 3 to 6 weeks, even without treatment. It will eventually heal on its own. However, the underlying syphilis infection remains and will progress to secondary syphilis if left untreated.
How is it diagnosed?
Visual Examination: A doctor may suspect syphilis based on the appearance of the chancre.
Dark-Field Microscopy: A sample from the chancre is examined under a special microscope to identify Treponema pallidum bacteria.
Blood Tests: Blood tests (e.g., RPR, VDRL, FTA-ABS, TPPA) can detect antibodies to syphilis. Blood tests are often done to confirm the diagnosis. Blood tests may not be positive immediately after the chancre appears, so repeat testing may be needed.
Timeline of Symptoms
Incubation Period: 10-90 days (average 21 days) between infection and the appearance of the chancre.
Primary Syphilis (Chancre): Appears 3 weeks (average) after infection. Lasts 3-6 weeks and heals spontaneously.
Secondary Syphilis: If untreated, secondary syphilis may develop weeks to months after the chancre heals.
Important Considerations
Syphilis is a serious infection: Untreated syphilis can lead to severe health problems, including damage to the brain, heart, nerves, eyes, and other organs. It can also cause neurosyphilis (infection of the brain and spinal cord).
Syphilis in pregnancy: Can be transmitted to the fetus, leading to congenital syphilis, which can cause serious health problems or death for the infant. Pregnant women should be screened for syphilis early in pregnancy.
Increased risk of HIV: Syphilis increases the risk of acquiring and transmitting HIV.
Treatment is crucial: Early diagnosis and treatment with antibiotics are essential to prevent the progression of syphilis and its complications.
Follow-up is necessary: After treatment, follow-up blood tests are needed to ensure that the infection has been eradicated.
Coinfection: It is important to get tested for other sexually transmitted infections (STIs) as well.