Donovanosis physical examination: Difference between revisions

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==Overview==
==Overview==
Clinically, the disease is commonly characterized as painless, progressive ulcerative lesions without regional [[lymphadenopathy]].
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]], [[Prepuce|subpreputial]] region, and [[anus]]. Common locations in females include: [[labia minora]], [[cervix]], and [[fourchette]].


==Physical Examination==
==Physical Examination==
*In early stages donovanosis commonly presents as a nontender, progressive [[Ulcer|ulcerative]] lesions without regional [[lymphadenopathy]].<ref name=" O'Farrell"></ref>
*In early stages donovanosis commonly presents as a nontender, progressive [[Ulcer|ulcerative]] lesions without regional [[lymphadenopathy]].<ref name="O'Farrell" />
:*90% of cases involve [[genital]] region
:*90% of cases involve [[genital]] region
:*10% of cases involve [[inguinal]] region
:*10% of cases involve [[inguinal]] region
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*Serpiginous outline<ref name="Richens">{{cite journal| author=Richens J| title=The diagnosis and treatment of donovanosis (granuloma inguinale). | journal=Genitourin Med | year= 1991 | volume= 67 | issue= 6 | pages= 441-52 | pmid=1774048 | doi= | pmc=PMC1194766 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1774048  }} </ref>
*Serpiginous outline<ref name="Richens">{{cite journal| author=Richens J| title=The diagnosis and treatment of donovanosis (granuloma inguinale). | journal=Genitourin Med | year= 1991 | volume= 67 | issue= 6 | pages= 441-52 | pmid=1774048 | doi= | pmc=PMC1194766 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1774048  }} </ref>


Four variants can be further classified according to their clinical presentation:<ref name=" O'Farrell">{{cite journal| author=O'Farrell N| title=Donovanosis. | journal=Sex Transm Infect | year= 2002 | volume= 78 | issue= 6 | pages= 452-7 | pmid=12473810 | doi= | pmc=PMC1758360 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12473810  }} </ref>
Four variants can be further classified according to their clinical presentation:<ref name="O'Farrell">{{cite journal| author=O'Farrell N| title=Donovanosis. | journal=Sex Transm Infect | year= 2002 | volume= 78 | issue= 6 | pages= 452-7 | pmid=12473810 | doi= | pmc=PMC1758360 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12473810  }} </ref>
{| style="font-size: 85%;"
{| style="font-size: 85%;"
! style="width: 160px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Type}}
! style="width: 160px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Type}}
! style="width: 300px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Clinical Appearance}}
! style="width: 300px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Clinical Appearance}}
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" | '''Ulcerogrnulomatous'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" | '''Ulcerogranulomatous'''
| style="background: #F5F5F5; padding: 5px;" | beefy red, non-tender, bleeds easily
| style="background: #F5F5F5; padding: 5px;" | beefy red, non-tender, bleeds easily
|-
|-
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===Common Locations in Males===
===Common Locations in Males===
*[[Sulco coronal]]
*[[Coronal sulcus]]
*[[Balanopreputial]] region
*[[Prepuce|Subpreputial]] region
*[[Anus]]
*[[Anus]]<ref name=" O'Farrell"></ref>


===Common Locations in Females===
===Common Locations in Females===
*[[labia minora]]
*[[Labia minora]]
*Vaginal furcula
*[[Cervix]]
*[[Cevix]]
*[[Fourchette]]<ref name=" O'Farrell"></ref>
*[[Fourchette]]


===Extragenital Lesion Locations===
===Extragenital Lesion Locations===
Extragenital lesions occur in 6% of patients, typically in the following locations:<ref name="Richens"></ref>
Extragenital lesions occur in 6% of patients, typically in the following locations:<ref name="Richens" />
:*[[Mouth (human)|mouth]]
:*[[Mouth (human)|mouth]]
:*[[cheek]]
:*[[cheek]]
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[[Category:Sexually transmitted infections]]
[[Category:Sexually transmitted infections]]
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Infectious disease]]
 
[[Category:Disease]]
[[Category:Disease]]


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Latest revision as of 17:37, 18 September 2017

Donovanosis Microchapters

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Overview

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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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