Dermatology - Lymphogranuloma Venereum

Dermatology - Lymphogranuloma Venereum 
Lymphogranuloma venereum is a sign of the sexually transmitted infection C. trachomatis. It can show up in the genital, rectal, or pharyngeal areas, based on where the sexual contact took place.
This is mostly an illness of the lymph nodes and lymphatics. In the drainage field of the injection site, painful lymphangitis and lymphadenitis happen, followed by perilymphangitis and periadenitis. If you have lymphadenopathy in the inguinal area, you can see that the Poupart ligament separates the femoral lymph node from the groin lymph node.

A primary genital lesion is only seen in about one-third of men and very rarely in women. When it is seen, it is a small, painless bump or ulcer that doesn't swell up and heals in a few days on the penis, labia, rear vagina, or fourchette. Lymphangitis and lymphadenitis lead to tonecrosis 2 to 6 weeks after being exposed. At first, the nodes are separate, but as the periadenitis gets worse, they become tangled and move around and swell up. The skin on top of it gets stiff, red, and thin, and it forms several leaking fistulas. As the infection goes away, acute inflammation is replaced by fibrosis, which blocks lymphatic flow and causes chronic edema and stricture.

The diagnosis is based on symptoms and is proven by lab results; nucleic acid amplification is the best method, and cell culture with antigen testing is a good second choice.
Primary syphilis, chancroid, inguinal hernia, plague, tularemia, tuberculosis, and cancer are on the list of possibilities.
Oral erythromycin base 500 mg four times a day for 21 days or 100 mg of doxycycline twice a day for 21 days.