No abstract

SUMMARY Primary syphilis of the palpebral conjunctiva of the lower eyelid is reported because it is rare, which makes its diagnosis difficult but important. Accepted for publication 2 March 1989 positive result at a titre of 1/16, and the T pallidum haemagglutination assay (TPHA) also gave a positive result. Gram's stain of the scrape material gave a negative result for Haemophilus ducreyi bacilli. Smear and culture studies for Neisseria gonorrhoeae, Trichomonas vaginalis, and Candida albicans gave negative results. His total blood count was 8.2 x 109/1, and the differential count was 70% polymorphs, 28% lymphocytes, and 2% eosinophils. The erythrocyte sedimentation rate was 4 mm in the first hour. A Mantoux test gave a negative result. Analysis of the cerebrospinal fluid and radiography of the chest and long bones showed no abnormalities. Histopathological examination of the ulcer showed perivascular infiltration with lymphocytes and plasma cells and a breach in the epithelium.The patient was treated with a single deep intramuscular injection of benzathine penicillin 2.4 MIU, and the lesion had healed completely within six days. Routine clinical and serological follow up studies undertaken during the following 10 months showed a Figure Primary syphilitic chancre oflower left palpebral conjunctiva.

No abstract