Brief Answer: It could be syphilis Detailed Answer: Hi, Thanks for writing to us. A painless skin ulcer persistent since months could be a chancre or syphilitic ulcer provided there was a sexual contact with affected person. So I would like to know If there is any history of sexual contact outside marriage. If yes, whether it was protected or unprotected If it was with a known partner or unknown partner. If partner has history of sexual contact with other persons any investigations done so far. Also attach an image of the ulcer as it would help me in diagnosing the disease. Hoping to hear from you soon. Take care

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Brief Answer: It could be syphilis chancre Detailed Answer: Hi, Thanks for uploading the image. I have gone through it and in my opinion it looks like a syphilitic chancre. A simple investigation like VDRL in dilution would confirm the same. If at all its not syphilitic chancre, then a biopsy may be required to rule out other unlikely possibilties like Zoon's balanitis or a malignancy etc Also I would like to know if you have any other skin lesions or may be small patches of hair loss etc. Hope this helped. Take care

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Brief Answer: Get VDRL done. Detailed Answer: Hi, Thanks for writing back. I would advise that you get a VDRL done prior to circumcision. A simple test like VDRL could confirm or simply rule out syphilis altogether. If it comes back negative, as advised a biopsy should be done to rule out non infectious or a malignant cause. The biopsy can be taken during circumcision by your operating surgeon. Take care

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