Malignant syphilis in an AIDS patient

Abstract

Malignant syphilis is an uncommon, but not unknown, ulcerative variation of secondary syphilis. The lesions typically begin as papules, which quickly evolve to pustules and then to ulcers with elevated edges and central necrosis. It is usually, but not mandatory, found in patients with some level of immunosuppression, such as HIV patients, when the TCD4(+) cell count is >200 cells/mm(3). Despite the anxiety the lesions cause, this form of the disease has a good prognosis. The general symptoms disappear right after the beginning of treatment, and lesions disappear over a variable period. This study reports the case of a 27-year-old man who has been HIV positive for 6 years, uses antiretroviral therapy incorrectly, has a TCD4(+) cell count of 340 cells/mm(3), a VDRL of 1:128 and itchy disseminated hyperchromic maculopapular lesions with rupioid crusts compatible with malignant syphilis.

Malignant syphilis accompanied with neurosyphilis in a malnourished patient: A case report

“…The occurrence of malignant syphilis together with neurosyphilis and malnutrition, as shown in the present case, is extremely rare. A few cases of malignant syphilis have been reported in the literature, most of which had no neurosyphilis or HIV infection[3,15]. In the present case, the patient was not HIV positive, and therefore one of the main risk factors for the development of both malignant syphilis and neurosyphilis was absent.…”

Case report of three consecutive lues maligna infections in an HIV-infected patient

“…Lues maligna is predominantly found in immunodeficient patients such as patients with HIV or AIDS [1][2][3][4][5][6] but also occurs in immunocompetent individuals. 7 The classic lesion of lues maligna is an oval, papulopustular skin lesion with well-demarcated borders sometimes covered with a lamellar crust (Figure 1(a)), but myriad clinical presentations of this disease also exist.…”

Secondary syphilis presenting as a corymbiform syphilide: case report and review

“…Patients infected with the human immunodeficiency virus (HIV) tend to have a greater frequency of aggressive and unusual clinical phenotypes of syphilis 2 . We have recently had the opportunity to care for some patients with unusual clinical presentations of syphilis during the course of HIV infection 3 - 6 . We now report the case of a male patient in whom secondary syphilis presented with an exceedingly rare type of lesion: a corymbiform (or corymbose) syphilide.…”