Dermatologic Manifestations of Lymphogranuloma Venereum
- Author: Jose A Plaza, MD; Chief Editor: Dirk M Elston, MD more...
Background
Lymphogranuloma venereum (LGV) is a primarily cutaneous, and sometimes systemic, sexually transmitted disease (STD), which primarily affects lymphatic tissue of the groin. LGV is caused by unique serotypes L1, L2, and L3 of Chlamydia trachomatis. LGV occurs only sporadically in North America, but it is endemic in many parts of the developing world. A recent outbreak of LGV proctocolitis has been reported among homosexual men in North America and Europe, and many of these individuals were co-infected with HIV.[1, 2, 3, 4, 5, 6, 7]
Pathophysiology
Lymphogranuloma venereum (LGV) is caused by C trachomatis, an obligate intracellular pathogen (ie, the bacterium lives within human cells), and strains L1, L2, and L3 have been associated with infection. LGV is primarily a disease of lymphatic tissue. Because Chlamydia species cannot traverse the intact epithelial barrier, access to lymphatic vessels is gained through microtrauma in the skin or mucous membranes. The pathogen then enters the draining lymph nodes, causing lymphangitis or lymphadenitis. The causal pathologic process involves thrombolymphangitis and perilymphangitis and the consequent spread of the inflammatory reaction from the affected lymph nodes to surrounding tissues.
Epidemiology
Frequency
United States
Lymphogranuloma venereum (LGV) is rare in the United States, and the true incidence is not known.
International
Lymphogranuloma venereum (LGV) is most common in Southeast Asia, Africa, Central America, and the Caribbean. LGV accounts for 2-10% of genital ulcer disease in India and Africa.[8]
Mortality/Morbidity
Progression to the third phase of lymphogranuloma venereum (LGV) can result in serious and permanent sequelae such as genital deformity, fistulas, and rectal strictures, among others. Complete cure is achieved by early recognition of LGV and appropriate antibiotic treatment.
Race
Lymphogranuloma venereum (LGV) is found more commonly in blacks.
Sex
Lymphogranuloma venereum (LGV) is significantly more common in men than in women.
Age
The peak range for lymphogranuloma venereum (LGV) is in individuals aged 15-40 years.
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