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Q. How can the symptomless ulcer at the back of penile shaft be treated?

Answered by
Dr. Shanza Ikram
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Mar 07, 2019

Hello doctor,

Small painless itchless ucler at the back of penile shaft with no other symptoms.

Dr. Shanza Ikram

Dermatology
#

Hi,

Welcome to icliniq.com.

I have gone through your case. According to your description and clinical picture (attachment removed to protect patient identity), this ulcer could be a manifestation of primary chancre of syphilis (one of the sexually transmitted diseases, if there is a history of sexual contact as well at least 3 to 4 weeks ago).


The Probable causes:

Sexually transmitted infection syphilis.

Investigations to be done:

VDRL, TPHA, test for other STD like hepatitis B and C, HIV.

Differential diagnosis:

Traumatic.

Probable diagnosis:

Primary chancre of syphilis.

Treatment plan:

Benzathine penicillin 1.2 MU I/M on each buttock stat dose. If tests are normal then only Fucidin acid cream two times a day.


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Thank you doctor,

Could it be something that is not an STD like from friction or something else?

Dr. Shanza Ikram

Dermatology
#

Hi,

Welcome back to icliniq.com.

Yes, that is the second differential. As I have already told you that it could be traumatic as well. Trauma means friction or by a sharp nail or anything which have broken the skin. In that case, apply Fucidin acid cream two times a day for seven days. But try to exclude STD first.


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