Related Therapeutic strategies

Herpes simplex virus (HSV) occurs in 2 common locations: orofacial (usually due to HSV-1) and genital (usually due to HSV-2).

Read more

Seborrheic dermatitis can be limited to the scalp, but it also can involve the face and any hairy or intertriginous area and rarely can even progress to a generalized erythroderma.

Read more

Chancroid

Timothy Berger Bruce Wintroub

Saturday, January 01, 2011

The diagnosis of chancroid is usually clinical, although improved culture techniques allow isolation of the causative organism H. ducreyi. The therapeutic strategy is to eliminate the pathogenic microorganism.

Read more

Therapeutic Strategies

Chancroid

Timothy Berger Bruce Wintroub

Saturday, January 01, 2011

Overview

The diagnosis of chancroid is usually clinical, although improved culture techniques allow isolation of the causative organism H. ducreyi. The therapeutic strategy is to eliminate the pathogenic microorganism.

Initial Steps

Azithromycin 1 g orally as a single dose.

Alternative Steps

  1. Ceftriaxone 250 mg intramuscular in a single dose.
  2. Ciprofloxacin 500 mg twice daily for 3 days.
  3. Erythromycin 500 mg three times daily for 7 days.

Subsequent Steps

  1. Successfully treated ulcers will show symptomatic improvement by 3 days and evidence of healing by 7 days. If the patient fails to improve and the diagnosis is correct, consider coexistent HIV infection, antibiotic resistance, a second coexistent sexually transmitted infection, and noncompliance.
  2. Inguinal nodes (buboes) may continue to progress despite adequate treatment. Aspirate fluctuant nodes with a large-bore needle.
  3. Evaluate all patients for other sexually transmitted diseases.
  4. Sexual contacts of infected persons must be traced and treated.

Pitfalls

  1. The antimicrobial sensitivity of H. ducreyi is regionally variable and evolving. Direct therapy by known antibiotic sensitivity patterns in the community of acquisition.
  2. Look for simultaneous infection by herpes simplex and/or syphilis.
  3. Gram stain for diagnosis is not always reliable.

Back to Therapeutic Strategies

CONTENT PROVIDED BY:
Derm101.com Logo

Disclaimer: The material above has been prepared by Derm101.com. It has not been reviewed by the DermQuest Editorial Board for its accuracy or reliability. Reference to any products, service, or other information does not constitute or imply endorsement, sponsorship, or recommendation by members of the Editorial Board.