Images in Dermatology
Misleading Genital Ulcer
Úlcera genital imitadora
M.M. Palacios
, J.S. Abad, V.P. Sanjuan
Corresponding author
Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, Spain
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Palacios, J.S. Abad, V.P. Sanjuan" "autores" => array:3 [ 0 => array:4 [ "nombre" => "M.M." "apellidos" => "Palacios" "email" => array:1 [ 0 => "mariamatellanes@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J.S." "apellidos" => "Abad" ] 2 => array:2 [ "nombre" => "V.P." "apellidos" => "Sanjuan" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Úlcera genital imitadora" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 447 "Ancho" => 1250 "Tamanyo" => 88173 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 21-year-old woman with no relevant history consulted for the presence of a single, painless, oval, ulcerative genital lesion with indurated borders, located on the right lateral wall of the vaginal introitus (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). She did not report general malaise or any systemic symptoms, but did acknowledge having had unprotected unsafe sex. Based on clinical suspicion of a syphilitic chancre, a single dose of intramuscular benzathine penicillin was administered and additional tests were requested. Serology was negative for human immunodeficiency virus, hepatitis viruses B and C, and syphilis. Bacterial culture was positive for <span class="elsevierStyleItalic">Neisseria gonorrhoeae</span> and polymerase chain reaction for gonococcus was positive. A diagnosis of gonococcal infection was established and ceftriaxone monotherapy was prescribed based on the antibiogram results. An improvement in the lesion was observed 3 weeks after beginning treatment (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). A subsequent bacterial culture was negative for gonococcus. Serological tests for syphilis performed 5 weeks after the appearance of the ulcer were negative.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A hard chancre at the site of inoculation is characteristic of primary syphilis, but is a rare presentation of gonorrhea. We describe a case of gonococcal infection that simulated primary syphilis, manifesting with a typical syphilitic chancre. This case underscores the importance of confirming the diagnosis. There are few descriptions in the literature of genital gonorrhea presenting as a hard chancre.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">This study did not receive any form of external funding.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-10-15" "fechaAceptado" => "2019-01-22" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Palacios MM, Abad JS, Sanjuan VP. Úlcera genital imitadora. Actas Dermosifiliogr. 2021;112:72.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 447 "Ancho" => 1250 "Tamanyo" => 88173 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011200000001/v1_202101161046/S1578219020303747/v1_202101161046/en/main.assets" "Apartado" => array:4 [ "identificador" => "41141" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Dermatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011200000001/v1_202101161046/S1578219020303747/v1_202101161046/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020303747?idApp=UINPBA000044" ]
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