Gummatous penile ulceration and generalised lymphadenopathy in homosexual man: case report.

Nodular secondary syphilis with associated granulomatous inflammation: case report and literature review

“…Similar to our patient, papular or nodular clinical lesions were most common in granulomatous secondary syphilis . However, macular, papulosquamous, plaque‐like, annular and ulcerated lesions were also observed . These non‐nodular cases represent ‘older’ lesions of secondary syphilis of greater than 4‐weeks duration rather than granulomatous inflammation within true papular/nodular lesions of secondary syphilis …”

Gummatous ulcer of leg: an uncommon entity in present era

“…The gummas produce a chronic inflammatory state in the body with mass effects upon the local anatomy with cigarette paper scarring. Palatal and nasal septal perforations, blindness in one eye, hepatosplenomegaly, anterior bowing and thickening of tibia (sabre tibia) can also develop 4 .Only a minority of patients with untreated syphilis develop late sequelae, about 15% having gummatous lesions with skin and bone among the possible sites 5 .The tibia is the bone most commonly affected 6 .Gummatous ulcer can be present on other site like face, auricular region, penis and rarely eye 7,8,9 .Treatment of early syphilis is parenteral penicillin G. Patients with penicillin allergy can be treated with tetracycline or doxycycline. Ceftriaxone may be considered as an alternative therapy, although optimal dose is not yet defined.…”