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   Oct 12


The incubation period is usually from one to four weeks but can be much longer.

The disease begins as single or multiple subcutaneous nodules usually on the genitalia, which erode through the skin to produce painless ulcers or exuberant granulations. Anorectal lesions may occur in homosexual mea

Secondary infection may contribute to necrotic debris on an ulcer and an offensive sanguineous or purulent discharge may result. Surrounding cellulitis rarely occurs. The lesions are soft and friable and easily torn during childbirth.

Fibrosis occurs but is not marked. Phimosis or lymphoedema of distal tissues is common in the active phase of the disease.

There may be spread by autoinoculation to more distant sites particularly on the head, neck, groins, thighs and abdomen. Systemic spread may lead to granulomatous lesions of the liver, spleen, bone or joints.
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