Genital ulcers

Abstract

CASE A man aged 37 years presented with a three-day history of a penile ulcer and fatigue. He had a history of unprotected insertive anal intercourse with multiple male partners in the preceding four weeks. He had not travelled overseas or had contact with returned travellers. He had no significant medical history, no allergies and was not taking human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP). Examination revealed a 2 cm non-tender indurated ulcer at the penile coronal sulcus that had a clean base (Figure 1). There was a firm, non-fluctuant, non-tender inguinal lymph node on the right side.