Ulceration of the skin as a part of the syndrome of lymphogranuloma inguinale has not received much notice in the discussion of the clinical manifestations of this disease.
Huguier1 in 1848 described esthiomene as a chronic hypertrophy and ulceration of the vulva which may be associated with similar involvement of the vulvo-anal area, rectal ulceration or stricture. In the majority of his cases there was also infiltration of the inguinal lymph glands. He subdivided his entity into four main clinical groups: a hypertrophic vegetative type, an elephantiasic type, a type characterized by the formation of fistulas, and an ulcerative type.
Fournier2 in 1873 described the occurrence of a syndrome of indolent edema of the vulva which was frequently associated with inguinal lymphopathy. He believed that it was syphilitic in origin but distinct from his "syphilome anorectale." Ulceration of the vulva is not mentioned in his description.