(Disclaimer: This article is intended for general scientific purposes only. In order to protect the patient’s privacy, the relevant information in the following content has been processed.) Abstract: The patient was admitted to the clinic because of the appearance of ulcers around the genitals accompanied by pain. It was learned through understanding the patient’s specific situation that he had had high-risk sexual behavior in the past, but because he did not feel uncomfortable after the incident, he did not pay attention to it, and he was not aware of the severity of the expiration of the disease until recently. Combined with the patient’s examination results, a preliminary diagnosis of stage 1 syphilis combined with noma was made, and the patient’s condition has been relieved through the administration of symptomatic oral medication and infusion therapy. Basic information] Male, 45 years old [Type of disease] noma (stage 1 syphilis combined with soft chancre) [Hospital] Eastern Theater General Hospital [Time of consultation] January 2020 [Treatment plan] medication (injectable benzylpenicillin combined with roxithromycin tablets) [Treatment cycle] 2 months, outpatient review for 1 year [Effect of treatment] The patient’s symptoms have been relieved. The patient came to our hospital with “ulcers on the glans with pain for 1 week”. Through careful questioning of his medical history, we learned that the patient had a history of high-risk sexual contact for many times in the past, and recently he found that small red papules had appeared on the glans by accident, which did not concern him at the beginning, but he found that the number of them had gradually increased and the papules had gradually enlarged, and eventually formed ulcers, which led to obvious pain in him. The patient experienced obvious pain. At that time, he went to the nearest hospital for treatment, but his symptoms did not improve significantly, so he came to our hospital immediately, and was admitted to our outpatient clinic with “penile ulcers with pain”. After the patient was admitted to the hospital, he was examined by the relevant specialties, which indicated that the patient’s inguinal lymph nodes were obviously enlarged, and although there was obvious pressure and pain, there was no ulceration. There was obvious edema of the penile foreskin, which made it difficult to turn out, and the edge of the ulcer in the middle of the glans near the coronal sulcus was clearly demarcated. Blood tests were positive for toluidine red unheated serum test, positive for syphilis-specific antibodies, and negative for HIV. The secretion from the base of the ulcer showed short rod-shaped bacilli arranged in chains with bluntly rounded ends. Combined with the patient’s clinical characteristics and laboratory results, the patient was finally diagnosed with first-stage syphilis combined with soft chancre, and the treatment needed to be benzylpenicillin for injection combined with roxithromycin tablets. After the first week of treatment, the patient’s self-conscious pain was obviously reduced, and the pain basically disappeared in the second week of treatment; meanwhile, the patient’s ulcer area and secretion were gradually reduced and minimized in the course of treatment. At the end of the first month of treatment, the patient’s swollen lymph nodes had disappeared and the ulcers had all healed, while the noma had met the criteria for clinical cure. In addition, the patient’s syphilis symptoms gradually disappeared after 1 month of treatment. However, since syphilis is very easy to recur, the patient still needs to take regular checkups, routinely checking the toluidine red non-heating serum test once every three months, and the results of the checkups turn negative after one year. Precautions Seeing the patient’s symptoms gradually reduced, I am very pleased, but in order to the patient’s health, we still need to remind the patient to pay attention to some of the matters in daily life: 1, remind the patient to pay attention to the care of the ulcerated surface, such as try to open the foreskin to let the ulcerated surface exposed, but need to avoid the foreskin flap caused by the pus secretion contact with the other parts of the normal, which may cause infections; 2, the patient in the disease is not fully cured before to strictly avoid Sexual life, at the same time the patient’s intimate apparel, towels and other closely contacted items should be strictly disinfected to avoid contact infection; 3, the diet as light as possible, avoid greasy, spicy and stimulating food, such as hot pot, chili, seafood, etc., it is recommended to achieve a balanced intake of nutrients, quit smoking and limit alcohol, and to develop a good habit of life, do not stay up all night. Appropriate increase in daily physical exercise can improve their own resistance and immunity, which will help alleviate the condition. V. Personal insights Syphilis is relatively common in clinical practice, so most doctors usually think of troubleshooting for syphilis when they see ulcers in the genital area in the outpatient clinic, but because the ulcers in this patient are slightly different from the hard chancre, we also need to rule out other abnormalities. Combined with the fact that the patient had obvious high-risk sexual contact behavior, the patient’s diagnosis was basically clear. After the administration of symptomatic drugs, the patient’s symptoms gradually improved, while the patient achieved the desired outcome throughout the course of the disease.