Annular secondary syphilis

Ramoni, Stefano; Ponziani, Alessandra; Boneschi, Vinicio; Pastena, Andrea; Cusini, Marco

doi:10.23736/s0392-0488.17.05627-9

Cited by 6 publications

(8 citation statements)

References 2 publications

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“…In such cases, a positive serology is not sufficient for diagnosis and a histopathological examination is generally required. 6 In our case, the demonstration of TP presence within the lesions supported the diagnosis of secondary syphilis making skin biopsy unnecessary. Although no NAAT for TP has been approved by the U.S. Food and Drug Administration, the method that specifically amplifies the tpp47 gene is well known for its high sensitivity and high specificity.…”

Section: Discussion Of the Casesupporting

confidence: 62%

Secondary syphilis with extra-genital condyloma lata: A case report and review of the literature

et al. 2022

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Background Syphilis is known as the “great imitator” because of its polymorphic clinical manifestations. Condyloma lata are an uncommon mucocutaneous manifestation of secondary syphilis, generally localized in intertriginous areas, such as the genitals and anus. Extragenital localization of condyloma lata is considered unusual. Methods A case study of extra-genital condylomata is presented. To contextualise the case, a literature review of extra-genital condylomata lata was subsequently undertaken. The authors searched MEDLINE/PubMed, Scopus and Excerpta Medica/EMBASE English-language sources using the following keywords: “condyloma lata”, “condylomata lata”, and “condyloma latum”. Results Thirty-five papers (from 1940 to 2021) describing an extra-anogenital localization of condyloma lata were found and are summarized in Table 1. Patients were mainly males (82.1%), with a mean age of 31.9 years. Most of them showed other manifestations of secondary syphilis (53.9%). In a minority of cases (39.0%), concomitant anogenital condyloma lata were present, thus making the diagnosis easier. The toe web localization was the most documented (26.2%) followed by the oral cavity (23.8%). Conclusion In the presence of extra-genital condyloma lata, the differential diagnosis is not always clear, especially when no other muco-cutaneous lesions are observed. In the case of eroded or wet lesions involving any cutaneous fold, associated or not with other cutaneous manifestations, a sexual history should be obtained, and syphilis must be considered.

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Section: Discussion Of the Casesupporting

confidence: 62%

Secondary syphilis with extra-genital condyloma lata: A case report and review of the literature

et al. 2022

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“…Annular syphilis is more common in children and black patients during the late secondary stage, and often involves the scalp, face, palm, sole, and intertriginous and genital regions. [1][2][3][4] Appearances may range from mildly raised lesions with scaly borders to verrucous plaques. 1 Localized annular syphilis on the genitalia has been rarely reported in HIV-negative cases, and should be distinguished from granuloma annulare, annular lichen planus, annular psoriasis, scabies, and dermatophytosis.…”

Section: Discussionmentioning

confidence: 99%

“…1 Localized annular syphilis on the genitalia has been rarely reported in HIV-negative cases, and should be distinguished from granuloma annulare, annular lichen planus, annular psoriasis, scabies, and dermatophytosis. [2][3][4] The main dermoscopic findings of secondary syphilis are Biett's collarette and yellow-orangish hue, while the vascular pattern is indefinite. [5][6][7] Typical Biett's collarette presents as a circular, thin, scaling edge progressing in an outward direction and surrounded by an erythematous halo.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological, dermoscopic, and ultrastructural observation of annular secondary syphilis on the penis

Huang

Chen

et al. 2020

Int J STD AIDS

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Annular syphilis may range from mildly raised lesions with scaly borders to verrucous plaques. Localized annular syphilis on the genitalia has been rarely reported in HIV-negative cases. This paper reports a case of annular secondary syphilis on the penis. Dermoscopy showed peripheral dotted and short linear vessels and white scaling with a relatively clear central area in an erythematous annular plaque. Histopathology revealed mild hyperkeratosis, parakeratosis, psoriasiform acanthosis, and focal basal vacuolar degeneration with lichenoid, perivascular, and periadnexal infiltrate of lymphohistiocytes and plasma cells in the superficial dermis. Silver stain showed several spirochetes in the lower epidermis and superficial dermis. Electron microscopy revealed a few intercellular and intracytoplasmic spirochetes in the basal epidermis and free spirochetes in the papillary dermis. Rapid plasma reagin and Treponema pallidum particle agglutination assays were positive. The lesions disappeared after intramuscular benzathine penicillin, with no relapse at six-month follow-up.

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“…Clinicians should be well trained to recognize the atypical presentations of syphilis, especially in patients who have already received a syphilis diagnosis, since its incidence is steadily increasing in Europe, especially in men having sex with men. 1 , 7…”

Section: Case Reportmentioning

confidence: 99%

“…6 Every site of the body can be involved by annulararciform lesions but the most commonly affected is the ano-genital area. [7][8][9] To our knowledge, annulararciform lesions of the palms as unique manifestations of SS have never been described.…”

Section: Case Reportmentioning

confidence: 99%

Annular and arciform lesions of the palms as unique manifestations of secondary syphilis

et al. 2020

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We describe a patient presenting with annular-arciform symmetric lesions of the palms as the unique manifestation of secondary syphilis. The polymorphism of skin lesions in secondary syphilis depends entirely on the degree of inflammatory infiltrate, the level of vascular involvement and the resulting ischemia of the skin. Besides the transient and diffuse maculo-papules (roseola syphilitica), secondary syphilis skin lesions may have different morphology and shape. It has already been reported that in cases of reinfections by Treponema pallidum the skin lesions may be arciform, as in our patient, and asymmetric. Indeed, previous syphilis may attenuate the clinical and laboratory manifestations of a new infection with T.pallidum, that occurs with less severe skin manifestations or presents as latent syphilis. However, to our knowledge, annular-arciform lesions of the palms as unique manifestations of secondary syphilis have never been described. Clinicians should be well trained to recognize the atypical presentations of syphilis, especially in patients who have already received a syphilis diagnosis, since its incidence is steadily increasing in Europe, especially in men having sex with men.

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Annular secondary syphilis

Cited by 6 publications

References 2 publications

Secondary syphilis with extra-genital condyloma lata: A case report and review of the literature

Secondary syphilis with extra-genital condyloma lata: A case report and review of the literature

Clinicopathological, dermoscopic, and ultrastructural observation of annular secondary syphilis on the penis

Annular and arciform lesions of the palms as unique manifestations of secondary syphilis

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