Diagnostic Considerations

The diagnosis of lymphogranuloma venereum (LGV) should not preclude a thorough search for other sexually transmitted diseases (STDs) (eg, granuloma inguinale, syphilis, chancroid) that may be cured by different treatment modalities. The use of broad-spectrum antibiotics to replace an accurate differential diagnosis and focused treatment should be discouraged.

The diagnosis of LGV may be missed easily in women and homosexual males because they tend not to present with the classic inguinal lymphadenopathy. Careful diagnostic consideration should be used in these patient populations.

Primary lesion considerations include the following:

Genital herpes
Primary syphilis
Chancroid
Genitoanorectal syndrome
Crohn disease
Rectal strictures resulting from carcinoma

Differential Diagnoses

Workup

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Media Gallery

Lymphogranuloma venereum is caused by the invasive serovars L1, L2, or L3 of Chlamydia trachomatis. This young adult experienced the acute onset of tender, enlarged lymph nodes in both groins. Courtesy of Wikimedia Commons (Herbert L. Fred, MD, and Hendrik A. van Dijk, http://cnx.org/content/m14883/latest/).

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Author

Jose A Plaza, MD Director of Dermatopathology, Professor of Pathology and Dermatology, The Ohio State University Wexner Medical Center

Jose A Plaza, MD is a member of the following medical societies: American Medical Association, American Society for Clinical Pathology, American Society of Dermatopathology, International Society of Dermatopathology

Disclosure: Nothing to disclose.

Coauthor(s)

Victor G Prieto, MD, PhD Ferenc and Phyllis Gyorkey Chair for Research and Education in Pathology, Professor, Departments of Pathology and Dermatology, University of Texas MD Anderson Cancer Center

Victor G Prieto, MD, PhD is a member of the following medical societies: American Association for the Advancement of Science, American Medical Association, American Society for Clinical Pathology, American Society of Dermatopathology, College of American Pathologists, European Society of Pathology, International Society of Dermatopathology, Society for Investigative Dermatology, United States and Canadian Academy of Pathology

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Myriad (consultant regarding MyPath test in melanocytic lesions).

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Texas Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Jennifer D. Lorek, MD, Scott M. Acker, MD, Peter Langenstroer, MD, and Milton W. Datta, MD, to the development and writing of this article.

Sections Dermatologic Manifestations of Lymphogranuloma Venereum
Overview
Presentation
DDx
Workup
Treatment
Medication
References

Dermatologic Manifestations of Lymphogranuloma Venereum Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

Tables

Contributor Information and Disclosures

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