central ulceration at the glans penis

A 21-year old college student and self-described as a “ladies’ man” presents to the clinic because of a concerning spot that developed on his penis. He complains of pain at the spot but denies itching. He reports no fever. When asked further about his sexual practices, he reports no condom use because his partners are all “on the pill.” He had chlamydia in high school but is otherwise healthy. The rest of the pertinent medical histories are unremarkable. His review of systems is negative. VS: BP 120/80; HR 70; RR 16; T 98.0 F; Pain level 3/10 On examination of the penis, you find a 1-cm tender, erythematous papule with a deep central ulceration at the glans penis. There is some mild, tender lymphadenopathy in the inguinal area. The rest of the examination is unremarkable.