There are 3 distinct stages in the course of the disease. In the first stage, after a 3- to 30-day incubation period, a small, painless papule or pustule develops that may erode to form an ulceration. This lesion is often asymptomatic and heals without scarring within 1 week.
The second or inguinal stage begins 2-6 weeks after the primary lesion and consists of painful inflammation of the inguinal and/or femoral lymph nodes. There may be prominent systemic symptoms of fever, chills, and malaise.
The third stage of disease is called the genito-anorectal syndrome. In women in particular, it may present after asymptomatic first and second stages. Patients initially present in the third stage with proctocolitis, followed by perirectal abscesses, strictures, fistulas, and rectal stenosis.
A55 – Chlamydial lymphogranuloma (venereum)
186946009 – Lymphogranuloma Venereum
Differential Diagnosis & Pitfalls
- Cellulitis / superinfected erosions
- Herpes simplex virus (HSV) or herpes zoster
- Granuloma inguinale
- Carcinoma – squamous cell, basal cell
- Behçet syndrome
- Fournier or gas gangrene
- Hidradenitis suppurativa
- Pyoderma gangrenosum
- Ecthyma gangrenosum
- Inflammatory bowel disease – Crohn disease, ulcerative colitis