Print version ISSN 0365-0596
An. Bras. Dermatol. vol.86 no.3 Rio de Janeiro May/June 2011
IMAGES IN TROPICAL DERMATOLOGY
Granuloma inguinale (Donovanosis)*
Sarita Maria de Fátima Martins de Carvalho BezerraI; Marcio Martins Lobo JardimII; Valdir Bandeira da SilvaIII
IPhD in Dermatology. Voluntary Professor at the Recife Center for Studies in Dermatology (CEDER), Recife, Pernambuco, Brazil
IIMedical student, Boa Viagem School of Medicine, Professor Fernando Figueira Institute of Integrated Medicine, Recife, Pernambuco, Brazil
IIIAdjunct Professor of Clinical Dermatology, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
The authors present images of two of the most common clinical forms of granuloma inguinale (donovanosis) in males and females. Donovanosis is considered a sexually transmitted disease that is endemic in tropical and subtropical regions of the world. Two microscopic images are also shown, one of a direct smear (the presence of Donovan bodies within large mononuclear cells identified using Giemsa stain) and the other of typical histological findings (rod-shaped Donovan bodies within a mononuclear histiocyte).
Keywords: Communicable diseases; Genital diseases, female; Genital diseases, male; Sexually transmitted diseases; Sexually transmitted diseases, bacterial
Donovanosis, also known as granuloma inguinale, is a chronic, benign condition caused by an intracytoplasmic, gram-negative bacillus called Klebsiella granulomatis, previously referred to as Calymmatobacterium granulomatis.1,2,3 The disease is endemic in Brazil, but has been in decline for several decades. It constitutes around 5% of all sexually transmitted infections. 2,4 It begins with a nodule or papule at the site of bacterial inoculation, which bursts, leading to the formation of an ulcer that grows slowly, bleeds easily and is painless. From then on, the manifestations are directly associated with the host's tissue response, resulting in localized or extensive forms of the disease or even in visceral lesions by hematogenous dissemination (Figure 1). Inguinal adenopathy is not present in any of the clinical variants. 3,4 Laboratory diagnosis is performed by direct investigation of Donovan bodies in ulcer smears obtained by punch biopsy or by a biopsy performed on the ulcer (Figure 2). 3
1. Jardim ML. Donovanose: proposta de classificação clínica. An Bras Dermatol. 1987;62:169 -72. [ Links ]
2. Martins S. Granuloma inguinale:self assessment . J Am Acad Dermatol. 1996;34:3324. [ Links ]
3. Lupi O, Madkan V, Ryring SK. Tropical Dermatology: bacterial tropical disease. J Am Acad Dermatol. 2006;54:559-78. [ Links ]
4. Brown TJ,Yen-Moore A, Tyring SK. An overview of sexually transmitted disease Part I. J Am Acad Dermatol. 1999;41:511-32. [ Links ]
Mailing address: Approved by the Editorial Board and accepted for publication on 23.03.2010 * Work conducted at the STD outpatient clinic, Clinics Hospital, Federal University of Pernambuco (PE), Brazil.
Sarita Maria de Fátima Martins de Carvalho Bezerra
Rua Ernesto Paula Santos - 187, 301 Bairro: Boa Viagem
51021330 Recife - SP, Brasil
Tel: (81) 3465 3930
Conflict of interest: None
Financial funding: None
Approved by the Editorial Board and accepted for publication on 23.03.2010
* Work conducted at the STD outpatient clinic, Clinics Hospital, Federal University of Pernambuco (PE), Brazil.