|
?:definition
|
-
WHAT: Gonococcal skin lesions. Gonococcal Skin Lesions: hemorrhagic or vesicopustular skin lesions characteristically seen in disseminated gonococcal infections. WHY: The presence of gonococcal skin lesions in a patient with arthritis is highly suggestive of gonococcal arthritis. HOW: Two types of mature skin lesions are consistently seen in gonococcal bacteremia. One is a hemorrhagic (purpuric) papule. The other is a vesicopustular lesion on an erythematous base. Both lesions begin as pinpoint erythematous macules, and typically appear during the first day of symptoms in association with a febrile episode. The purpuric lesions do not blanch with local pressure and often are found on the palms and the soles. They last about a week gradually fading from a dark blue color to a dark brown and then a light brownish yellow color. The vesicopustular lesions evolve through papular, vesicular and pustular stages reaching a maximum diameter of about 2.5 cm. All these stages may be present at the same time. The mature lesion is elevated, slightly umbilicated and surrounded by an erythematous areola. It usually involutes after 4-5 days. The lesions are usually tender and are located on the distal parts of the extremities. The trunk of the body is generally not involved with either lesion. In some cases the purpuric element predominates, while in others the pustular predominates. Rarely, a third variant, a hemorrhagic bulla, will be the sole skin manifestation of gonococcal bacteremia. REFS: 1) Holmes, KK; Counts, GW and Beaty, HN: Disseminated gonococcal infection. Ann Intern Med 74:979, 1971. 2) Ackerman, AB: Hemorrhagic bullae in gonococcemia. N Engl J Med 282:793, 1970. DN19233-3.
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}