Hard chancre is seen in?

Ans. b (Syphilis). (Ref. Harrison, Internal Medicine, 15th ed., 845, 990, 1045, 1191 and 1220).Chancres are seen in chancroid, syphilis, tularemia, African trypanosomiasis and few other parasitic diseases. SyphilisChanchroid1PapulePustule2Usually singleUsually multiple, coalesce35-15 mm diameterDiameter variable4Sharp edges, elevated and roundUndermined ragged irregular edges5Superficial/deepExcavated6Base smooth and nonpurulentBase purulent, bleeds easily7Firm consistency (indurated)Soft consistency, non-indurated8Not painful or tender lesions with firm non-tender bilateral adenopathy.Very tender lesions with tender, suppurated unilateral adenopathy.