Groove sign:

Ans. b (LGV) (Ref. IADVL 2nd edition, 1466-1469)LYMPHOGRANULOMA VENEREUM# Sexually transmitted disease of lymph channels caused by Chlamydia trachomatis type L1,L2 and L3.# Characterized by a small fleeting primary lesion followed by the development of suppurative regional lymphadenopathy.# Inguinal syndrome or bubo is characterized by inflammatory swelling of the inguinal lymph nodes and their corresponding tributaries and branches.# Enlargement of the femoral lymph nodes is observed in about 20% of cases.# When these and the inguinal lymph nodes are enlarged, they are separated by Poupart's ligament,producing a groove- "Groove sign of Greenblatt" - it is pathognomonic of LGV.# Other features:- Proctocolitis,- Ramrod penis,- Prostatitis,- Seminal vesiculitis,- Epididymoorchitis,- Urethral stricture,- Genital elephantiasis,- Vaginal stenosis- Urethral strictures.- Anal fissures and strictures.- Hepatitis, endocarditis, arthritis, pneumonitis, spondilytis, erythema nodosum and erythema multiforme.# Diagnosis:1. Serological tests: complement fixation test, micro immunofluorescence test and single L-type immunofluorescence test2. Histologic identification:Giemsa-Romanowskv stain3. Isolation: inoculation into mouse brain, yolk sac or tissue culture4. Frei test# Rx:- Tetracycline 500 mg qid for 2-3 weeks- Doxycycline 100 mg bd for 2-3 weeks- For pregnant and children below 8 yrs erythromycin is given.Educational Points:# Tzanck test: Pemphigus# Tzanck smear: Herpes# Tzanck cell: Keratinocyte