From the Guidelines
A chancre is the primary lesion of syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum, characterized by a firm, painless, non-itchy ulcer with a clean base and raised borders at the site of infection. This definition is based on the most recent and highest quality study available, which describes the clinical manifestations of syphilis, including the primary infection characterized by an ulcer or chancre at the infection site 1.
Key Characteristics of a Chancre
- Typically appears on the genitals, rectum, or mouth
- Develops about 3-4 weeks after infection
- Heals on its own within 3-6 weeks, even without treatment
- Highly infectious, with direct contact transmitting the disease
Importance of Medical Attention
The presence of a chancre should prompt immediate medical attention for proper diagnosis through blood tests and dark-field microscopy.
Treatment Options
Treatment typically involves penicillin G benzathine 2.4 million units as a single intramuscular injection for primary syphilis. For those allergic to penicillin, alternatives include doxycycline 100mg twice daily for 14 days or tetracycline 500mg four times daily for 14 days, as recommended by the Centers for Disease Control and Prevention 1.
Notification of Sexual Partners
Sexual partners should also be notified and treated to prevent further transmission of the disease.
From the Research
Definition of a Chancre
- A chancre is a solitary, painless lesion that typically presents as the primary symptom of syphilis 2.
- It is usually found on the genitals, but can also occur on other parts of the body 2.
Characteristics of a Chancre
- A chancre is usually painless and solitary 2.
- It can be found on the genitals, anus, or other parts of the body 2.
- The chancre is a hallmark of primary syphilis and is often accompanied by other symptoms such as fever, lymphadenopathy, and rash in the secondary stage of the disease 2.
Diagnosis and Treatment
- The diagnosis of syphilis, including the presence of a chancre, may involve dark-field microscopy of skin lesions, but most often requires screening with a nontreponemal test and confirmation with a treponemal-specific test 2.
- Parenterally administered penicillin G is considered first-line therapy for all stages of syphilis, including primary syphilis characterized by a chancre 2, 3, 4.
- Alternative regimens for nonpregnant patients with no evidence of central nervous system involvement include doxycycline, tetracycline, ceftriaxone, and azithromycin 2, 5, 6.