Donovanosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]; Kiran Singh, M.D. [3]; Nate Michalak, B.A.

Overview

Donovanosis is commonly characterized as painless, progressive ulcerative lesions without regional lymphadenopathy. Patients in later stages may present with scarring, elephantiasis-like swelling of genitals or perianal area, or stenosis of the urethra, vagina, or anus. Typical lesion characteristics include: beefy red color, nontender, emitting rank odor, elevated above skin, smooth and rolled edge, serpiginous outline. Physical examination of lesions can classify donovanosis into ulcerogranulomatous, hypertrophic, necrotic, and sclerotic variants. Common locations in males include: coronal sulcus, subpreputial region, and anus. Common locations in females include: labia minora, cervix, and fourchette.

Physical Examination

  • Patients in late stages present with the following signs:[2]

Typical Lesion Characteristics

  • Beefy red color
  • Nontender
  • Emit rank odor
  • Elevated above skin
  • Smooth, rolled edge
  • Serpiginous outline[3]

Four variants can be further classified according to their clinical presentation:[1]

Type Clinical Appearance
Ulcerogranulomatous beefy red, non-tender, bleeds easily
Hypertrophic or Verrucous irregular edge, dry
Necrotic foul smelling, deep, tissue destruction
Sclerotic dry, cicatricial, fibrous scar tissue

Common Locations in Males

Common Locations in Females

Extragenital Lesion Locations

Extragenital lesions occur in 6% of patients, typically in the following locations:[3]

Gallery

References

  1. 1.0 1.1 1.2 1.3 O'Farrell N (2002). "Donovanosis". Sex Transm Infect. 78 (6): 452–7. PMC 1758360. PMID 12473810.
  2. Velho, Paulo Eduardo Neves Ferreira; Souza, Elemir Macedo de; Belda Junior, Walter (2008). "Donovanosis". Brazilian Journal of Infectious Diseases. 12 (6). doi:10.1590/S1413-86702008000600015. ISSN 1413-8670.
  3. 3.0 3.1 Richens J (1991). "The diagnosis and treatment of donovanosis (granuloma inguinale)". Genitourin Med. 67 (6): 441–52. PMC 1194766. PMID 1774048.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 "Dermatology Atlas".
  5. 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 "Public Health Image Library (PHIL)".


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