REPORT OF A CASE
A 33-year-old man with lymphadenitis in the left side of his groin, myalgias, headache, and fever was admitted to the hospital. Two weeks earlier, he had returned from a 3-month trip to southern India. His illness had begun approximately 2 weeks before he returned; at that time, he noted progressive enlargement and tenderness of nodes in the left side of his groin. There was no recent history of malaise, weight loss, fevers, or sweats.On examination, the patient had difficulty walking because of extreme pain in the inguinal region. His temperature was 38.4¼C; other vital signs were normal. The cutaneous examination showed an 8×8-cm tender, swollen left inguinal mass with positive "groove signs" and tenderness on palpation (Figure 1). The patient also had an ecthymatous ulcer on his left heel. The ulcer, which was 1 cm in diameter, was discrete and round and appeared "punched out." It was surrounded by an erythematous and scaly areola and covered by a purulent and crusted exudate (Figure 2). There were no signs of cellulitis, lymphangitis, or genital ulceration. The findings of the rest of his skin examination were normal.Laboratory tests included a complete blood cell count
Duve S, Voack C, Rakoski J, Hoffmann H. Extensive Inguinal Lymphadenitis. Arch Dermatol. 1996;132(7):826. doi:10.1001/archderm.1996.03890310113021
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