N Classification of cutaneous Diagnostic considerations tuberculosis 1 Exogenous Tuberculosis sporotrichosis, leishmaniasis, cutaneous
chancre atypical mycobacteriosis, Tuberculosis syphilis, cat scratch disease and tularemia Tuberculosis paracoccidioidomycosis, verrucosa cutis leishmaniasis, sporotrichosis, tuberculosis verrucosa and chromomycosis.
Secondary syphilis develops 6 weeks after
chancre emergence and is characterized by constitutional symptoms, skin lesions, mucosal lesions and systemic involvement.
Other differences include, HIV-positive patients tend to have more than one
chancre, a larger and deeper primary lesion, higher rate of asymptomatic primary syphilis, more aggressive secondary syphilis and increase rate of early neurological involvement.
A study of 689 HIV-positive men attending two big Phoenix-area HIV clinics found that provider counseling consisting of
chancre photos, sexual risk assessment, and counseling on the impact of syphilis encouraged men to look for sores more often in oral and rectal areas.
Watson's vision enables her to read Fulton's work more profoundly, alert to "myriad tiny insurrections" in its pages similar to the graffiti that defaces
Chancre's campaign posters; "no one notices them but they're there, near-invisible, and count for something" (18).
Differential diagnoses include pyoderma, herpetic whitlow, cowpox, pseudocowpox (milker's nodule), cat-scratch disease, anthrax, tularemia, pri-mary inoculation tuberculosis, atypical mycobacteriosis, syphilitic
chancre, sporotrichosis, keratoancanthoma, and pyogenic granuloma (5).
The primary stage is characterized by the appearance of a painless sore, the
chancre, and the secondary stage is often marked by a maculopapular rash involving the palms of the hands and the soles of the feet, mucocutaneuous lesions, and lymphadenopathy.
(3,4) Approximately 5-15 days post-infection, a trypanosomal
chancre, caused by the accumulation of trypanosomes in the connective tissue, may form at the site of the tsetse fly bite.
The
chancre characteristic of primary syphilis begins as a papule and then erodes.