Case and Research Letter
Painful Enlarged Inguinal Lymph Nodes After Unprotected Sex
Adenopatías inguinales dolorosas tras relaciones sexuales sin protección
M.S. Vallejo-Ruiz
, T. Kueder-Pajares, A. Hernández-Núñez, J. Borbujo
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Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
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Identificando las características de la micosis fungoide en poblaciones suramericanas" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "91" "paginaFinal" => "94" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Histopathology of Mycosis Fungoides in a Colombian Population: Towards the Characterization of South American Populations" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1617 "Ancho" => 1750 "Tamanyo" => 708255 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hallazgos relevantes poco descritos. a) Vacuolización extensa de la capa basal (4×) b) Detalle de vacuolización de la basal (10×) c) Vacuolización de la capa basal con borramiento de la interfase por los linfocitos atípicos (10×). 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Vallejo-Ruiz, T. Kueder-Pajares, A. Hernández-Núñez, J. Borbujo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M.S." "apellidos" => "Vallejo-Ruiz" "email" => array:1 [ 0 => "mariadelasoledad.vallejo@salud.madrid.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Kueder-Pajares" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Hernández-Núñez" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Borbujo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Adenopatías inguinales dolorosas tras relaciones sexuales sin protección" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 688 "Ancho" => 1005 "Tamanyo" => 116698 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Elastic, nodule in the groin, not adhered to the deep layers, measuring 4 cm, which had appeared 2 weeks earlier, with normal overlying skin.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 23-year-old man who visited our department with a painful swelling in the left groin area that had appeared 2 weeks earlier. The patient had no fever, systemic symptoms, or constitutional symptoms. The patient’s personal past history included a gonococcal infection and multiple high-risk homosexual relations. Physical examination revealed a painful, elastic, subcutaneous nodule not adhered to the deep layers, measuring 4 cm, with normal overlying skin (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The patient presented no oral, genital, or anal lesions, or urethral secretion, and presented no enlarged lymph nodes in the neck, axillae, or groin, nor accompanying skin lesions.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A sexually transmitted infection was suspected and serology, cultures, and PCR of an anal and a urethral sample for <span class="elsevierStyleItalic">Chlamydia trachomatis</span> and <span class="elsevierStyleItalic">Neisseria gonorrhoeae</span> were requested. All serology and microbiological studies were negative.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Three weeks later, the patient presented with an increase in size of the nodule in the left groin; the nodule then measured 8 cm, with a discrete fluctuation, and ultrasound was performed, together with fine-needle aspiration of the content of the lesion for a microbiological study. Ultrasound of the left groin showed multiple nodular images with hypervascularization, compatible with enlarged lymph nodes of significant size and appearance (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). PCR of the aspirate was positive for serovar L <span class="elsevierStyleItalic">C. trachomatis</span>.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">In light of the diagnosis of lymphogranuloma venereum (LGV), the patient was treated with doxycycline at a dosage of 100 mg every 12 hours for 21 days, with complete remission of clinical symptoms.</p><p id="par0025" class="elsevierStylePara elsevierViewall">LGV is a sexually transmitted infection caused by serovars L1, L2, and L3 of <span class="elsevierStyleItalic">Chlamydia trachomatis</span>, which is endemic in tropical countries of Asia and the Americas.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a> It is transmitted via vaginal, anal, or oral sexual contact. This infection was rare in Europe until 2003, when the incidence of cases of the disease began to increase, mainly affecting men who have sex with HIV-positive men.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3–6</span></a> The growing incidence of this disease in Spain led it to be included as a disease subject to mandatory reporting, individualized since 2015.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The clinical presentation of LGV varies depending on the geographic location of the cases. Classical presentation of LGV, typical of Asia and the Americas, is divided into 3 phases: the first phase is characterized by a painless sore at the inoculation site, which appears between 3 and 30 days after contact; the second phase involves the appearance of painful enlarged lymph nodes; and the final phase involves lymphedema and elephantiasis due to the irreversible destruction of the lymphatic system if left untreated.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In Europe, this sexually transmitted infection manifests as proctitis with rectal pain, tenesmus, anorectal bleeding, and constipation, which can develop into abscesses, fistulae, and rectal stenosis if not treated in the initial phases of the disease. These clinical signs and symptoms require a differential diagnosis with other causes of proctitis, such as inflammatory bowel disease.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2,5,6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The diagnosis of LGV consists of detecting the nucleic acids of <span class="elsevierStyleItalic">C. trachomatis</span> in the exudate of the anogenital sore, rectal exudate, or the aspirate from fluctuating enlarged lymph nodes. It is common for the PCR of anal and urethral samples to be negative in the second phase of LGV, with positive results in 20% of rectal samples and 0.8% of urethral samples; a microbiological study of the lymph-node aspirate is therefore useful.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> If infection with <span class="elsevierStyleItalic">C. trachomatis</span> is confirmed, the serovar is then identified.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3</span></a> It is important to note that screening for this infection should be performed in men who have sex with men who have had receptive anal relations in the previous 6 months.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,8</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The first line of treatment for LGV is 100 mg of oral doxycycline every 12 hours for 21 days, which produces complete resolution in most cases.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3,8</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Vallejo-Ruiz MS, Kueder-Pajares T, Hernández-Núñez A, Borbujo J. Adenopatías inguinales dolorosas tras relaciones sexuales sin protección. Actas Dermosifiliogr. 2022;113:89–90.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 688 "Ancho" => 1005 "Tamanyo" => 116698 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Elastic, nodule in the groin, not adhered to the deep layers, measuring 4 cm, which had appeared 2 weeks earlier, with normal overlying skin.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 576 "Ancho" => 1005 "Tamanyo" => 72754 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ultrasound of the groin showing a hypoechogenic nodular image compatible with enlarged lymph nodes.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphogranuloma venereum: diagnostic and treatment challenges" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Ceovic" 1 => "S.J. Gulin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/IDR.S57540" "Revista" => array:6 [ "tituloSerie" => "Infect Drug Resist" "fecha" => "2015" "volumen" => "8" "paginaInicial" => "39" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25870512" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Approach to lymphogranuloma venereum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. O’Byrne" 1 => "P. MacPherson" 2 => "S. DeLaplante" 3 => "G. Metz" 4 => "A. Bourgault" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Can Fam Physician" "fecha" => "2016" "volumen" => "62" "paginaInicial" => "554" "paginaFinal" => "558" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27412206" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2013 European guideline on the management of lymphogranuloma venereum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H.J. De Vries" 1 => "A. Zingoni" 2 => "A. Kreuter" 3 => "H. Moi" 4 => "J.A. White" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jdv.12461" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2015" "volumen" => "29" "paginaInicial" => "1" "paginaFinal" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26059819" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphogranuloma venereum among men who have sex with men. An epidemiological and clinical review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N.H. De Vrieze" 1 => "H.J. de Vries" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1586/14787210.2014.901169" "Revista" => array:6 [ "tituloSerie" => "Expert Rev Anti Infect Ther" "fecha" => "2014" "volumen" => "12" "paginaInicial" => "697" "paginaFinal" => "704" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24655220" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Linfogranuloma venéreo en España, 2005-2015: revisión de la bibliografía" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Diaz" 1 => "M. Ruiz-Algueró" 2 => "V. Hernando" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medcli.2018.05.036" "Revista" => array:5 [ "tituloSerie" => "Med Clin" "fecha" => "2018" "volumen" => "151" "paginaInicial" => "412" "paginaFinal" => "417" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudio descriptivo de los 102 primeros casos de un brote de linfogranuloma venéreo detectado en la Comunidad de Madrid" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Puerta López" 1 => "M. Rodríguez Domínguez" 2 => "B. Menéndez Prieto" 3 => "M. Vera García" 4 => "P. Clavo Escribano" 5 => "M. Villa Escamilla" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Multidisc Sida" "fecha" => "2013" "volumen" => "1" "paginaInicial" => "70" "paginaFinal" => "71" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and epidemiological characterisation of lymphogranuloma venereum in southwest Spain, 2013–2015" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Parra-Sánchez" 1 => "S. García-Rey" 2 => "I.P. Rodríguez" 3 => "P.V. Fernández" 4 => "M.J. Sánchez" 5 => "J.C.P. Folía" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Sex Transm Infect" "fecha" => "2016" "volumen" => "92" "paginaInicial" => "629" "paginaFinal" => "631" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Consensus document on the diagnosis and treatment of sexually transmitted diseases in adults, children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "AIDS Study Group (GESIDA)" 1 => "National Aids Plan" 2 => "STI Study group of the SEIMC (GEITS)" 3 => "Spanish Group for the Investigation of Sexual Transmission Diseases of the Spanish Academy of Dermatology and Venerology" 4 => "Spanish Society for Pediatric Infectious (SEIP)" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eimc.2017.06.004" "Revista" => array:5 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2018" "volumen" => "36" "paginaInicial" => "576" "paginaFinal" => "585" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011300000001/v2_202202160543/S0001731022000084/v2_202202160543/en/main.assets" "Apartado" => array:4 [ "identificador" => "92870" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas científico-clínicas / Case and Research Letter" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011300000001/v2_202202160543/S0001731022000084/v2_202202160543/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022000084?idApp=UINPBA000044" ]
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