DONOVANOSI CRONICA ELEFANTIASICA

We describe a woman who had elephantiasis of the vulva dating from one year. In addition multiple ulcerations and fistulae on vulva, perineal and perianal region were also present. Direct microscopic examination of superficial smears from ulcers was negative for Donovanan's bodies. Histological examination of biopsy specimens made the identification of clusters of blue staining organisms within the cytoplasm of large histiocytes possible. Vulvar elephantiasis is a rare sequela of chronic donovanosis. Its pathogenesis is related to the granulomatous inflammatory process and concurrent fibroproliferative reaction inducing occlusion of the lymphatic vessels and chronic lymphedema. Problems of clinical and histological differential diagnosis with other elephantiatic condition involving the genital region are discussed.