Donovanosis (granuloma inguinale) with vulval pseudo-elephantiasis

A 24 year old Melanesian female from the Eastern Highlands of Papua New Guinea presented with chronic painless ulcers of the external genitalia, anus and thighs of many years' duration and marked left labial hypertrophy for one year. Scrapings from the ulcers contained large foamy mononuclear cells in which Donovan bodies were demonstrated. The ulcers responded to tetracycline therapy however she absconded after three weeks before surgical correction of the labial pseudo-elephantiasis could be carried out. Vulval pseudo elephantiasis of the magnitude present in this case is rarely seen in Papua New Guinea.