Ulcer molle

Ulcus molle: Description

Ulcer molle is one of a group of diseases transmitted mainly through unprotected sexual intercourse. Doctors also refer to sexually transmitted diseases, STD (sexually transmitted disease) – in the vernacular, they are referred to as venereal disease. The STDs include, for example, syphilis (hard chancre), gonorrhea, better known as “gonorrhea,” genital herpes, as well as HIV.

The soft chancre is similar in appearance to the hard chancre, but the disease process and the causative agents are completely different. Therefore, it is important that the two diseases are differentiated.

Ulcer molle occurs predominantly in the countries of South America, Southeast Asia and Africa. Occasionally, infections with the bacterial pathogen but also in the western industrialized countries can be observed. Men are about ten times more likely to be affected than women. However, not all women notice the infection, while men usually have typical symptoms. The obvious signs of disease are ulcers on the genitals. The ulcer molle does not heal by itself, but it can be treated well with antibiotics.

Ulcus molle: Symptoms

The ulcer molle causes quite characteristic symptoms. About two to ten days after sexual contact with an infected partner, the first symptoms appear. Initially, small, reddish papules form, which then turn into vesicles. From such a vesicle finally ulcer (Ulcus) emerges. This is surrounded by a red, slightly raised hem. In the middle of the ulcer is a small grayish-yellow colored pit. At the beginning, the ulcers have only a few millimeters in diameter. If not treated, however, they may increase in size to a diameter of up to two centimeters.

The ulcer feels soft when touched (hence the Latin term molle = soft) and causes pain. In men, the ulcers of the ulcer typically occur on the inside of the foreskin, on the glans edge and on the prepuce ligament. Slightly less common are the lesions on the glans penis shaft or the pubic mound.

In women, the ulcers appear especially on the large and small labia and in the vicinity of the urethral orifice. Also on the internal sex organs such as the vaginal mucous membrane and the cervix, the typical changes occur. Since they usually do not cause any pain in these areas, affected women usually do not notice the infection. The ulcerated skin lesions can also serve other pathogens as an entry portal. Therefore, the soft chancre may be a precursor to infections with HIV, genital herpes or syphilis.

Depending on the sexual practice, the ulcers of the soft chancre may in rare cases also occur on the oral mucosa or in the anal area.

If the ulcer molle is not treated, the infection progresses. The bacteria can then spread along the nearby lymphatics and cause inflammation there (ulcer moll lymphangitis). In the case of men, this can be manifested by small, cherry-sized abscesses in the area of ​​the penis root. About one to two weeks after the first signs of the disease, the pathogens reach the inguinal lymph nodes. These are then painfully swollen and abscesses can form here, which the doctor calls Ulcus molle Bubo. In extreme cases, such an abscess breaks and the pus empties outward.

Ulcer molle: causes and risk factors

The cause of ulcer molle is the bacterium Haemophilus ducreyi. Infection is almost always due to unprotected sexual intercourse, that is, when condoms are not used during sex. Through direct skin contact, the bacteria can then penetrate the skin or mucous membrane of the genitals via very small injuries that are usually invisible to the naked eye. Unlike circumcised men, STDs are more common in men with preserved foreskins. Therefore, the presence of the foreskin is considered a risk factor for infection with the ulcer molle. Lack of 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 favor that the pathogen also penetrates into other regions of the earth.

Ulcus molle: examinations and diagnosis

The externally visible changes in the skin and mucous membrane in ulcus molle are similar to other venereal diseases such as syphilis or genital herpes. These should be distinguished from one another in the diagnosis of ulcer molle. The doctor – usually a specialist in skin and venereal diseases – inquires in a detailed conversation, first, since when the complaints exist and how they express themselves. Information about sexual habits is also helpful to the doctor – for example, if the person had unprotected sex with partners whose health is uncertain.

Following the physical examination. The doctor looks at the external genitals and scans the lymph nodes of the inguinal region. For uncircumcised men, he pays particular attention to the area under the foreskin. In women, a gynecologist often diagnoses the ulcer molle. In addition to the external genital region, he also examines the inside of the vagina and the cervix. If the typical ulcerative lesions show up here, he will take a swab sample from the affected area (swab). The sample is then tested for bacteria in the laboratory. If the laboratory can detect the pathogen Haemophilus ducreyi, the diagnosis of ulcer molle is confirmed.

Ulcer molle can also be the portal of entry for other venereal diseases. For the most part, the doctor will therefore initiate further tests to rule out additional infections such as syphilis, herpes simplex viruses or HIV.

Ulcus molle: Therapy

Therapy with a ulcer molle is relatively simple and usually quite straightforward. The pathogen, Haemophilus ducreyi, is usually well-controlled by an antibiotic. The drug of choice is the antibiotic ceftriaxone, which the doctor once administered by syringe into the muscles. Alternatively, antibiotics such as azithromycin, ciprofloxacin or erythromycin are available in tablet form. However, the pathogen is more resistant to older antibiotics. If a lymph node abscess has formed during the infection, the doctor may need to surgically open it to drain the pus. In order to prevent a renewed infection, the partner concerned must be treated in any case. It is also advisable to abstain from sexual contact until the ulcer molle is completely healed.

Ulcus molle: Prevention

It’s relatively easy to stand up to STDs like Ulcer molle to protect. Always use condoms during sexual intercourse with people whose health you are not sure about. Apply 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 else you have had sex with in recent weeks.

Ulcer molle: Disease course and prognosis

The ulcer molle usually has a good prognosis, since the 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 individuals run the 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.