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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



Welcome to

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:


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



Welcome back to

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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