Solid chancres (sores), one or more, are most often located on the genitals, in places where microtrauma usually occurs during sexual intercourse. In men, this is the head, foreskin, less often the trunk of the penis; sometimes the rash may be inside the urethra. In homosexuals, they are found in the circumference of the anus, in the depths of the skin folds forming it, or on the mucous membrane of the rectum. In women, they usually appear on the small and large labia, at the entrance to the vagina, on the perineum, less often on the cervix. In the latter case, the ulcer can be seen only during gynecological examination on the armchair with the help of mirrors.
Almost chancres can occur anywhere: on the lips, in the corner of the mouth, on the chest, lower abdomen, on the pubis, groin, tonsils, in the latter case resembling a sore throat, in which the throat is almost painless and the temperature does not rise. In some patients, there is a compaction and swelling with severe redness, even blue skin, in women - in the region of the labia majora, in men - the foreskin. With the attachment of the "secondary", i.e. additional infection, complications develop. In men, this is most often inflammation and edema of the foreskin (phimosis), where pus usually accumulates and sometimes one can feel the seal in place of the existing chancre. If, during the period of increase in edema of the foreskin, it is pushed aside and the head of the penis is opened, then the reverse movement is not always possible and the head turns out to be restrained by the sealed ring.
It swells and if it is not released, it can die. Occasionally, such necrosis (gangrene) is complicated by ulcers of the foreskin or located on the glans penis.
About a week after the appearance of hard chancre, nearby lymph nodes (usually in the groin) painlessly increase, reaching the size of a pea, plum or even a chicken egg. At the end of the primary period, other groups of lymph nodes increase.