ABSTRACT
There are a large number of causes of genital erosions and ulcers, which often develop following the formation of a blister. Any blistering condition may result in genital ulcers. Syphilis is due to infection with the organism Treponema pallidum. This is a motile, regularly close-coiled spirochaete. There are often no symptoms. The most consistent finding of primary syphilis is the genital chancre (ulcer). A painless papule appears at the site of inoculation between 9 and 21 days after exposure. The onset of secondary syphilis may range from six weeks to six months after initial infection and the primary chancre may still be present when secondary lesions occur. The diagnosis may be made by dark-field microscopic examination of a smear taken from a chancre or lesion of secondary syphilis or from a lymph node aspirate. Serological testing of blood is necessary. The patient should be warned of the possibility of a Jarisch-Herxheimer reaction that may occur on initiation of therapy.
