Chancroid results from Haemophilus ducreyi, a short, nonmotile, gram-negative bacillus. Poor personal hygiene may predispose males—especially those who are uncircumcised—to this disease.

Phimosis and urethral fistulas may occur in males.

The patient may report unprotected sexual contact with an infected person or with unknown or multiple partners. He may complain of pain associated with ulcers and lymphadenopathy. He also may experience headaches and malaise (in 50% of patients).

An inspection of the genital area initially reveals single or multiple papules surrounded by erythema. These rapidly become pustular and then ulcerate. The ulcers are nonindurated with ragged edges, have a base of granulation tissue, and bleed easily. They range from 1 to 2 mm in diameter.

You may observe the ulcers on the prepuce, frenulum, coronal sulcus, shaft, or glans penis in a male patient. In a female patient, you may note ulcers on the labia, fourchette, vestibule, clitoris, cervix, or anus, although many females are asymptomatic. Rarely, you’ll observe lesions on the tongue, lip, or breast.

When you inspect the inguinal area within 2 to 3 weeks of onset, you’re likely to observe unilateral lymphadenopathy with overlying erythema. If the patient hasn’t received treatment, you may observe suppuration with bubo formation. Rupture of the abscess may follow.

On palpation, you may note tender, fluctuant inguinal nodes.