There is a marked tendency to the formation of fibrous tissue.
Symptomatology
The disease usually first shows itself as a papule or vesicle on the penis or labia minora. The process extends and the thin epidermal layer rubs off leaving a surface of granulations which bleed easily and give off a creamy discharge which is frequently very offensive.
Fig. 128.—Venereal granuloma. (After Martini; from Mense.)
The process usually extends from the penis to the groins by continuity and thence down the inner surfaces of the thigh. When the glans penis is involved there may be a fungating growth suggestive of epithelioma. In the female the process extends from the labia minora into the vagina and also to the labia majora and thence to the perineum and perianal region. Recto-vaginal fistulae often result. The process extends more rapidly and markedly when invading mucous membranes.
While the granulomatous process is advancing there is frequently cicatrization of the areas previously invaded forming a scar tissue which breaks down easily. There is little pain or itching and the general health is not impaired.
There is no enlargement of the lymphatic glands. Although the process extends by continuity yet it may also pass to parts in contact with the diseased area. While healing of affected skin tends to occur that of mucous membrane does not.
There is really very little tendency to ulceration.