Inguinal granuloma, there are so many symptoms

Inguinal granuloma is more common in male friends, with a male-to-female ratio of 2 to 3:1. In males, it is more common in the foreskin, coronal sulcus, frenulum, glans and penis, while in females, it is more common in the labia majora and minora, frenulum, perineum, cervix, etc. It can be seen in the perianal area in both men and women, and is especially common in homosexuals.

1. Onset

It is more common in males, with a male-to-female ratio of 2 to 3:1. The most common age group is 20 to 45 years old when sexual activity is active.

2. Incubation period

Since transmission requires repeated contact, the incubation period is uncertain, ranging from 8 to 80 days.

3. Predisposing sites

The lesions often occur in the external genitalia. In men, they are more common in the foreskin, coronal sulcus, frenulum, glans and penis, and in women, they are more common in the labia majora, minora, frenulum, perineum, cervix, etc. The lesions can be seen in the perianal area in both men and women, and are especially common in homosexuals. It can also spread to the nose, lips, oropharynx, limbs, chest, abdomen, buttocks, internal organs such as colon, liver, kidneys, epididymis, bone marrow, bones, and joints such as orbital bones, tibia, clavicle, sacroiliac joints, etc. through the blood and lymphatic pathways.

4. Characteristics of skin lesions

The initial lesion is a painless, dark red, moist papule in the external genitalia, which gradually develops into a subcutaneous nodule with a diameter of about 0.5 cm. Nodules can rupture and form ulcers. If they are co-infected with spirochetes, the tissue can rapidly undergo necrosis. As the ulcer continues to develop, proliferative beef red velvety granulation tissue may form at the base. It is hard in texture, has raised edges, and is wart-like. It bleeds easily when touched, and the surface is covered with serous purulent secretions with a foul odor. If left untreated, the ulcer will grow larger and deeper over time, and may affect the urethra, anus, etc. Severe tissue damage may form fistulas, which may not heal for a long time. Finally, due to the proliferation of fibrous tissue, a hypertrophic keloid-like protrusion is formed, but it does not heal and is accompanied by loss of pigmentation. Pathogens can be found in ulcers, granulation tissue and scar tissue. Due to autoinoculation, scattered small satellite ulcers may appear around the lesions.

5. Spread throughout the body

About 6% of patients spread the disease to other parts of the body through the blood or lymphatic channels, such as the skin of the face, mouth, chest, lower abdomen and buttocks, and may also spread to organs such as the liver, colon or epididymis.

6. Complications

Scar formation may lead to lymphatic obstruction, causing elephantiasis in the penis, scrotum, and vulva. It may also cause strictures of the urethra, vagina, rectum or anus due to scar formation and tissue adhesion. If ulcers and fistula scars do not heal for a long time, squamous cell carcinoma may occur.

7. Pseudobubonic

It occurs in the subcutaneous part of the groin and causes local swelling of the granuloma, but not lymph node enlargement, so it is called pseudobubo. It may also develop into granulomatous ulcers that are difficult to heal.

8. Course of disease

The disease progresses slowly and can last for several years or even more than a decade and cannot heal itself. Pregnancy progresses rapidly. In a small number of advanced patients, the lesions may become malignant and develop into squamous cell carcinoma.