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February 1979

Multiple Penile Chancres: An Atypical Manifestation of Primary Syphilis

Author Affiliations

From the Department of Dermatology, Skin and Cancer Unit, New York University Medical Center, New York. Dr Wade is now at the Naval Regional Medical Center, Portsmouth, Va.

Arch Dermatol. 1979;115(2):227. doi:10.1001/archderm.1979.04010020065022

We describe a patient who had " several simultaneous syphilitic chancres; we reemphasize the possibility of such an atypical clinical presentation of primary syphilis.

Report of a Case  A 20-year-old man had an active sexual history but no previous venereal disease. Approximately five days prior to seeking medical attention, he noticed the beginnings of several asymptomatic lesions on the penis. There was no associated urethral discharge or dysuria.Examination of the patient's penis revealed ten discrete, nontender, superficial ulcers on the glans and shaft; each ulcer had rolled, indurated borders (Figure). Bilateral inguinal lymphadenopathy was present. The remainder of the physical examination results were unremarkable.Dark-field examinations for Treponema pallidum were done on two of the lesions and were interpreted as negative. Material for direct smears, cultures for Haemophilus ducreii and Neisseria gonorrhoeae, and blood for VDRL test for syphilis and FTA-ABS tests were taken. A tentative diagnosis of chancroid was

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