Variants Some of clinical variants are as follows. Variant Characteristics Dwarf<unk>  Small, superficial, relatively painless ulcer. Giant<unk>  Large granulomatous ulcer at the site of a ruptured inguinal bubo, extending beyond its margins. Follicular<unk>  Seen in females in association with hair follicles of the labia majora and pubis; initial follicular pustule evolves into a classic ulcer at the site. Transient<unk>  Superficial ulcers that may heal rapidly, followed by a typical inguinal bubo. Serpiginous<unk>  Multiple ulcers that coalesce to form a serpiginous pattern. Mixed<unk>  Nonindurated tender ulcers of<unk>  appearing together with an indurated nontender ulcer of syphilis having an incubation period of 10 to 90 days. Phagedenic<unk>  Ulceration that causes extensive destruction of genitalia following secondary or superinfection by anaerobes such as Fusobacterium or Bacteroides.<unk> al ulcer Most often a tender, nonindurated, single large ulcer caused by organisms other than Haemophilus ducreyi; lymphadenopathy is conspicuous by its absence. Laboratory findings From bubo pus or ulcer secretions, H. ducreyi can be identified using special culture media; however, there is a <80% sensitivity. PCR-based identification of the organisms is available, but none in the United States are FDA-cleared. Simple, rapid, sensitive and inexpensive antigen detection methods for H. ducreyi identification are also popular. Serologic detection of H. ducreyi uses outer membrane protein and lipooligosaccharide. Most of the time, the diagnosis is based on presumptive approach using the symptomatology which in this case includes multiple painful genital ulcers. Differential diagnosis Despite many distinguishing features, the clinical spectrums of following diseases may overlap with<unk> : * Primary syphilis * Genital herpes Practical clinical approach for this STI as Genital Ulcer Disease is to rule out top differential diagnosis of Syphilis and Herpes and consider empirical treatment for<unk>  as testing is not commonly done for the latter. Comparison with syphilis There are many differences and similarities between the conditions syphilitic chancre and<unk> : ;Similarities * Both originate as pustules at the site of inoculation, and progress to ulcerated lesions * Both lesions are typically 1–2 cm in diameter * Both lesions are caused by sexually transmissible organisms * Both lesions typically appear on the genitals of infected individuals * Both lesions can be present at multiple sites and with multiple lesions ;Differences * Chancre is a lesion typical of infection with the bacterium that causes syphilis, Treponema pallidum *<unk>  is a lesion typical of infection with the bacterium Haemophilus ducreyi * Chancres are typically painless, whereas<unk>  are typically painful * Chancres are typically non-exudative, whereas<unk>  typically have a grey or yellow purulent exudate * Chancres have a hard (indurated) edge, whereas<unk>  have a soft edge * Chancres heal spontaneously within three to six weeks, even in the absence of treatment * Chancres can occur in the pharynx as well as on the genitals
Chancroid
Genital herpes
Tinea manuum
Demodicosis
Tinea faciei
Lentigo simplex
Tinea capitis
Melanosis coli