Diagnosis
It is usual to suspect a syphilitic process but the absence of gland involvement and secondary manifestations of syphilis negatives this.
It may be suggestive of tuberculous or epitheliomatous processes. The marked chronicity and tendency to scarring are striking.
Treatment
Excision of the entire granulomatous area going well into the normal skin has been thought by some to be the only cure.
Ordinary antisyphilitic treatment does not seem to have any effect and the good reports that have been made as to therapeutic success with salvarsan may have been due to diagnosing a syphilitic process as granuloma venereum. Radiotherapy has been recommended.
Local treatment with antiseptic or deodorant washes or ointments is necessary in these cases.
Antimony Treatment.—Breinl reports success in treatment by using tartar emetic injections. This treatment is now the standard one and the drug is given intravenously as described under treatment of leishmaniasis. It is also recommended to apply locally compresses soaked with a ½% solution of tartar emetic.