A lady approaches a physician for contraceptive advice. On examination, there were two symmetrical ulcers on vulva, which were well defined with firm base. Which of the following is the most likely cause:
Chancre is the primary lesion of primary syphilis.
• It is most commonly found on the labium majus, labium minus, fourchette, clitoris, urethral orifice or cervix but can be found anywhere on the lower genital tract.
• In 10% cases more than one primary lesion is present.
• The first manifestation is a small papule which breaks to form an ulcer.
• Ulcer is firm, painless with raised edges and granulomatous base.
• In fact any sort of discrete relatively painless ulceration on the vulva may be primary syphilitic lesion.
• Inguinal glands enlarge when the primary is on the vulva or lower vagina.
• Lymph nodes are hard, shotty, painless, and do not suppurate.
Chancre
Herpes
Syphilis
Malignancy