Nodulo-ulcerative and erythrodermic secondary syphilis in human immunodeficiency virus-infected individuals

També, Swagata; Zambare, Uddhao; Nayak, Chitra

doi:10.1177/0956462418815310

Cited by 8 publications

(8 citation statements)

References 15 publications

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“…It is also associated with decreased CD4 + T-cell counts and increased HIV viral loads. 4 Immunologic events that facilitate the development of MS are unknown, but it is reasonable to postulate that the loss of helper T cells is responsible. One study found 80% of HIV patients with MS had a CD4 count greater than 200 cells/mm 3 .…”

Section: Discussionmentioning

confidence: 99%

“…The clinical impact of HIV and syphilis co-infection is bidirectional; HIV alters the course of syphilis and syphilis also appears to adversely impact HIV disease progression and transmissibility. It is also associated with decreased CD4 + T-cell counts and increased HIV viral loads 4 . Immunologic events that facilitate the development of MS are unknown, but it is reasonable to postulate that the loss of helper T cells is responsible.…”

Section: Discussionmentioning

confidence: 99%

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Malignant Syphilis as an Initial Presentation of HIV Infection: A Case Report

Djawad¹

2021

Int J Dermatol Venereol

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Introduction: Malignant syphilis (MS) is a rare and severe variant of secondary syphilis that is frequently associated with HIV infection. The clinical impact of HIV and syphilis co-infection is bidirectional, and the presence of MS is associated with acute HIV infection. Clinically, MS is characterized by nodular and ulcerative lesions affecting the trunk and extremities, which are covered with thick crusts. The treatment of choice for MS remains benzathine penicillin G.Herein, we report a case in which MS was the initial presentation of HIV infection.Case presentation: A 35-year-old male patient came with the chief complaint of extensive erythematous nodular rash for the past one month, with notable ulceration on some lesions with annular configuration along with fever and malaise. Based on the abovementioned clinical, laboratory, and histopathologic findings, the patient was diagnosed with MS and HIV. The diagnosis was established based on histopathological examination and syphilis serological testing.Discussion: Cutaneous disorders are a frequent presenting feature of HIV infection. The clinical manifestations of syphilis in immunosuppressed patients are often severe and/or atypical. The patient was then treated with weekly intramuscular administration of 2.4 million units of benzathine penicillin G for 3 weeks and achieved rapid and significant clinical improvement, with no Jarisch-Herxheimer reaction.Conclusion: Co-infection with syphilis and HIV alters the course of both diseases, and most HIV-infected patients with syphilis have typical disease manifestations associated with decreased CD4+ T-cell counts.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Malignant Syphilis as an Initial Presentation of HIV Infection: A Case Report

Djawad¹

2021

Int J Dermatol Venereol

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“…Reports of erythroderma in adults related to secondary syphilis are limited and some associated with HIV. Co-infection of syphilis and HIV seems to alter the course of both diseases 4 . The cause of the massive recruitment of inflammatory cells in the skin of erythrodermic patients is of unknown origin and the pathophysiological mechanism is different, depending on the cause.…”

Section: Discussionmentioning

confidence: 99%

Erythroderma associated with secondary syphilis: A case report of unusual presentation and resurgence of the great imitator

Mendez¹,

Torres²,

Orozco³

et al. 2019

TURKDERM

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Frengi, spirochete Treponema Pallidum'un neden olduğu kronik bir enfeksiyondur. İkincil sifilizin geniş klinik sunumları ona "büyük taklitçinin" lakabı kazandırdı. Eritroderma, derinin çok çeşitli nedenlere bağlı olarak ortaya çıkan genelleşmiş bir enflamatuvar reaksiyonudur, ancak, sifilizin ortak bir kütanöz tezahürü olarak kabul edilmez. Burada, kliniğimize kronik tekrarlayan eritroderma öyküsü ile başvuran 74 yaşında bir İspanyol erkeğin olgusunu sunuyoruz. Önceden korunmasız cinsel ilişki dışında tıbbi geçmişi önemli değildi. Eritrodermanın nedenini belirlemek için kapsamlı çalışma sifiliz enfeksiyonu için pozitif sonuçlandı. Daha sonra sifiliz enfeksiyonunun tedavisi eritroderma remisyonuyla sonuçlandı.

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“…People living with human immunodeficiency virus (PLWH) are at increased risk for atypical or more aggressive presentations of secondary syphilis, including nodular or ulcerative lesions (lues maligna), keratoderma and en-plaque lesions. 1 Herein we present a case of secondary syphilis in person living with HIV with clinical and histological features suggesting tuberculoid leprosy. A high index of suspicion and complementary tests are mandatory for a correct diagnosis.…”

Section: Introductionmentioning

confidence: 97%

Secondary syphilis mimicking tuberculoid leprosy in an HIV-positive individual: a case report

et al. 2019

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Secondary syphilis is a polymorphic condition resulting from the hematogenous and lymphatic dissemination of Treponema pallidum. Human immunodeficiency virus-positive patients are in greater risk of atypical and severe forms of the disease. The most common manifestation is a generalized papulosquamous eruption with variable mucosal involvement. However, annular plaques, split commissural papules, crusted necrotic or ulcerated lesions are also frequent. Granulomatous lesions, both clinically and histologically, are less common and present a diagnostic challenge. We describe a case of secondary syphilis presenting as a granulomatous rash with both clinical and histological features of tuberculoid leprosy. Complementary tests and clinical suspicion are essential to ensure a correct diagnosis and avoid subsequent complications.

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Nodulo-ulcerative and erythrodermic secondary syphilis in human immunodeficiency virus-infected individuals

Cited by 8 publications

References 15 publications

Malignant Syphilis as an Initial Presentation of HIV Infection: A Case Report

Malignant Syphilis as an Initial Presentation of HIV Infection: A Case Report

Erythroderma associated with secondary syphilis: A case report of unusual presentation and resurgence of the great imitator

Secondary syphilis mimicking tuberculoid leprosy in an HIV-positive individual: a case report

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