American Medical Association Family Medical Guide - American Medical Association [255]
People who have chancroid have an increased risk of becoming infected with HIV, the virus that causes AIDS (see page 909), because chancroid can cause sores and bleeding, which can provide a site for the virus to easily enter the bloodstream.
Symptoms
The symptoms of chancroid usually develop about 3 to 10 days after contact with an infected person. Initially, small, tender, pus-filled blisters form in the genital area and around the anus. The blisters quickly rupture to form soft, shallow ulcers, which may expand and join together to form larger ulcers. Although ulcers in the genital area can be very painful in men, women often are not aware that they have them. In some cases, the lymph glands in the groin become tender and swollen and a shiny, red-surfaced abscess forms. The abscess may rupture and release pus.
Diagnosis
A diagnosis of chancroid is based on the symptoms and an examination of the ulcers. Because a chancroid ulcer may initially be mistaken for a skin lesion caused by syphilis (see page 483) or genital herpes (see page 482), a doctor usually examines a sample of discharge from the ulcer under a microscope to confirm the diagnosis.
Treatment
To treat chancroid, doctors prescribe antibiotics such as azithromycin or ceftriaxone. In some cases, a doctor uses a hollow needle and a syringe to remove pus from an abscess. The doctor will monitor the infection for at least 3 months after treatment is completed to make sure it has been eliminated. Healing time is directly related to the size of the ulcer; larger ulcers can take several weeks or longer to heal completely. In severe cases, deep scarring can result.
Pubic Lice
Pubic lice (also called crab lice or crabs) are tiny, wingless, parasitic insects the size of fleas. An adult pubic louse has a small, flat body and is either gray, white, or brown, so it blends into its surroundings and is difficult to see. The lice lay shiny white eggs, called nits, at the bottom of hair shafts, where they hatch 7 to 10 days later.
Pubic lice need blood to survive, but can live for up to 48 hours without a human host. The lice usually infest pubic hair, but they occasionally attach themselves to armpit hair, beards, mustaches, eyebrows, eyelashes, or the hair on a person’s head. In some cases, pubic lice infest the area around the anus and the hair on the hands, arms, legs, or trunk. An infestation usually involves fewer than a dozen lice.
Pubic lice can be transmitted by skin-to-skin contact with an infested person, sleeping in an infested bed, using an infested towel, wearing infested clothing, or, in some cases, by sitting on an infested toilet seat.
Symptoms
The symptoms of pubic lice usually develop about 5 days after infestation and include itching and skin irritation in the affected area (usually the pubic area) that worsens at night. The itching and skin irritation are an allergic reaction to the bites. (Resist the urge to scratch; scratching can spread the lice to other parts of the body.) If lice infest the eyebrows or eyelashes, the eyes may become itchy, watery, and reddened. If the infested area becomes infected, it can cause redness, swelling, tenderness, or drainage.
Diagnosis and Treatment
A diagnosis of pubic lice is based on the symptoms and an examination of the affected area. The lice and their nits may be visible to the naked eye or with a magnifying glass. A doctor may look at the lice under a microscope to confirm the diagnosis.
You can treat pubic lice at home by washing the affected area with a nonprescription medicated shampoo or lotion that contains a pesticide such as permethrin, lindane, or pyrethrins with piperonyl butoxide. Ask your doctor to recommend