All features are less common in women who often have asymptomatic illness. They are usually painful and tender with ragged undermined edges, sharply demarcated and with a necrotic base. 500 mg PO QID x 7 days. Spontaneous rupture of the buboe relieves the pain. Urethral and rectal strictures as well as fistulas can be seen.
Primary infection can also present as a urethritis without a local skin lesion.
Also can see characteristic histopathological changes. Growth of the organism is usually not practical. 500 mg PO QID x 21 days. Both regimens may need to be continued longer if patient is not healing well. The lesions continue to expand outward with destruction of normal tissue.