Behcet′s disease simulating secondary syphilis in an HIV-infected patient

Kharkar, Vidya; Yeole, Sachin; Mahajan, Sunanda; Gutte, Rameshwar; Khopkar, Uday; M.Sujatha,

doi:10.4103/0253-7184.112950

Cited by 8 publications

(3 citation statements)

References 3 publications

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“…Regarding mucocutaneous manifestations, a few case reports have demonstrated the similarity in manifestation between Behçet's disease and syphilis. [9,10] Cutaneous lesions in Behçet's disease occur in up to 80% of patients, presented in various combinations. Common forms include papulo-vesiculopustular eruptions and erythema nodosum.…”

Section: Discussionmentioning

confidence: 99%

Severe Cutaneous Manifestation of Malignant Syphilis in a Patient with Behçet’s Uveitis: A case report

Charoenphol,

Choopong,

Sitthinamsuwan

et al. 2024

Preprint

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Background Syphilis exhibits a wide range of clinical presentations, mimicking various systemic and ocular diseases. Ocular syphilis, in particular, manifests with multiple presentations, ranging from anterior uveitis to panuveitis, making it a potential differential diagnosis for Behçet uveitis. Here, we present a unique case of Behçet panuveitis that was undergoing immunomodulatory therapy and was complicated by ocular syphilis. Notably, this case also featured rare cutaneous manifestations associated with secondary syphilis, commonly known as malignant syphilis. Case presentation A 38-year-old Thai man with refractory end-stage Behçet panuveitis reported a maculopapular rash accompanied by increased intraocular inflammation. The escalation of immunomodulatory therapy, intended to manage the provisional diagnosis of active ocular and cutaneous Behçet’s disease, resulted in clinical deterioration, with the rash transforming into multiple noduloulcerative lesions. Syphilis infection was eventually diagnosed based on positive serological tests and the presence of spirochetes observed in a skin biopsy specimen. The patient was treated with intravenous penicillin G, resulting in an improvement in intraocular inflammation and resolution of noduloulcerative rashes. Conclusions Intraocular inflammation and mucocutaneous lesions in syphilis can mimic the presentation of Behçet’s disease. The introduction of immunomodulatory therapy may alter the clinical picture, leading to a severe and atypical presentation. A high index of suspicion for reevaluating serologic tests or performing tissue biopsies is warranted for an accurate diagnosis.

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Section: Discussionmentioning

confidence: 99%

Severe Cutaneous Manifestation of Malignant Syphilis in a Patient with Behçet’s Uveitis: A case report

Charoenphol,

Choopong,

Sitthinamsuwan

et al. 2024

Preprint

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show abstract

“…Regarding mucocutaneous manifestations, a few case reports have demonstrated the similarity in manifestation between Behçet’s disease and syphilis [ 9 , 10 ]. Cutaneous lesions in Behçet’s disease occur in up to 80% of patients, presented in various combinations.…”

Section: Discussionmentioning

confidence: 99%

Severe Cutaneous Manifestation of Malignant Syphilis in a Patient with Behçet’s Uveitis: A Case Report

Charoenphol,

Choopong,

Sitthinamsuwan

et al. 2024

Case Rep Ophthalmol

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Introduction: Syphilis exhibits a wide range of clinical presentations, mimicking various systemic and ocular diseases. Ocular syphilis, in particular, manifests with multiple presentations, ranging from anterior uveitis to panuveitis, making it a potential differential diagnosis for Behçet’s uveitis. Here, we present a unique case of Behçet’s panuveitis that was undergoing immunomodulatory therapy and was complicated by ocular syphilis. Notably, this case also featured rare cutaneous manifestations associated with secondary syphilis, commonly known as malignant syphilis. Case Presentation: A 38-year-old Thai man with refractory end-stage Behçet’s panuveitis reported a maculopapular rash accompanied by increased intraocular inflammation. The escalation of immunomodulatory therapy, intended to manage the provisional diagnosis of active ocular and cutaneous Behçet’s disease, resulted in clinical deterioration, with the rash transforming into multiple noduloulcerative lesions. Despite negative serologic tests for syphilis at baseline before initiating immunomodulatory therapy, syphilis infection was eventually diagnosed following reevaluation and the observation of spirochetes in a skin biopsy specimen. The patient was treated with intravenous penicillin G, resulting in an improvement in intraocular inflammation and resolution of noduloulcerative rashes. Conclusion: Intraocular inflammation and mucocutaneous lesions in syphilis can mimic the presentation of Behçet’s disease. The introduction of immunomodulatory therapy may alter the clinical picture, leading to a severe and atypical presentation. A high index of suspicion for reevaluating serologic tests or performing tissue biopsies is warranted for an accurate diagnosis.

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“…4 Similarly, the condition known as condylomata lata has been associated with secondary syphilis and is typically identified as a smooth, flat rash located on the genitalia and the anus. 5 However, many atypical genital and anal lesions that are characteristic of secondary syphilis can mimic other skin diseases including scrotal eczema, 6 Behçet’s disease, 7 and genital filariasis. 8 Our patient reported a six-month history of cauliflower-shaped vulvar lesions; the differential diagnosis for lesions of this type includes condyloma acuminatum, condylomata lata, squamous cell carcinoma, basal cell carcinoma, and verrucous carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Cauliflower-shaped lesions on a young woman’s vulva

et al. 2021

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A 20-year-old young woman with cauliflower-shaped lesions on her vulva was misdiagnosed as condyloma acuminatum. Further evaluation revealed positive serological tests for syphilis. On histological examination, and numerous plasma cells were seen to infiltrate the dermis heavily. The cauliflower-shaped lesions on vulva completely disappeared after benzathine penicillin treatment. Cauliflower-shaped lesions are a rare manifestation of secondary syphilis.

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Behcet′s disease simulating secondary syphilis in an HIV-infected patient

Cited by 8 publications

References 3 publications

Severe Cutaneous Manifestation of Malignant Syphilis in a Patient with Behçet’s Uveitis: A case report

Severe Cutaneous Manifestation of Malignant Syphilis in a Patient with Behçet’s Uveitis: A case report

Severe Cutaneous Manifestation of Malignant Syphilis in a Patient with Behçet’s Uveitis: A Case Report

Cauliflower-shaped lesions on a young woman’s vulva

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