Pruritic nodular secondary syphilis in a 61-year-old man with HIV infection

Rovira-López, Roger; Bertolín‐Colilla, Marta; Martín‐Ezquerra, Gemma

doi:10.1177/0956462416681921

Cited by 8 publications

(8 citation statements)

References 16 publications

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“…Pruritus has previously been described as an uncommon symptom in secondary syphilis 5,[9][10][11] and in a case of nodular secondary syphilis. 12 It is unclear why some patients with secondary syphilis present with nodular lesions. Some have hypothesized that this morphology may be due to a hypersensitivity reaction to the spirochete.…”

Section: Discussionmentioning

confidence: 99%

Nodular secondary syphilis in three HIV-positive patients: a case series

et al. 2020

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Nodular secondary syphilis is an uncommon variant of secondary syphilis. We identified three cases of nodular secondary syphilis at our institution. The first patient presented with a diffuse nodular rash that included his scrotum and penis. The second patient had disseminated skin-colored nodules with serosanguinous crust on his face, trunk, and extremities. The third patient had a pruritic papular and nodular rash with overlying crust. All three patients had a reactive rapid plasma reagin and tested positive for fluorescent treponemal antibody absorption. All were eventually confirmed to be human immunodeficiency virus-positive. Histopathological examination demonstrated inflammatory infiltrate in the dermis composed of lymphocytes, histiocytes, and plasma cells, and treponemal staining highlighted spirochetes in the dermis. The patients were successfully treated with intramuscular penicillin benzathine G. Physicians should be aware of nodular syphilis as a less common cutaneous manifestation of secondary syphilis. Prompt diagnosis of secondary syphilis can expedite resolution of the infection and avoid progression to tertiary syphilis.

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Section: Discussionmentioning

confidence: 99%

Nodular secondary syphilis in three HIV-positive patients: a case series

et al. 2020

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“…In these patients, classical cutaneous findings may often be lacking; instead, the 'great imitator' may present with atypical features, such as infiltrated papulo-nodular eruptions or disseminated plaques. [4][5][6][7][8][9] Papulo-nodular syphilis has been described also in immunocompetent, non-HIV-infected patients. 10 Typical findings in early stages of secondary syphilis are represented by macular, maculopapular or papulosquamous eruptions.…”

Section: Discussionmentioning

confidence: 99%

Secondary syphilis masquerading as lupus vulgaris in an HIV-infected patient: A diagnosis suggested by histology

et al. 2018

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We report a case of secondary syphilis mimicking lupus vulgaris in an HIV-infected patient. A 21-year-old Brazilian man presented with a two-month history of asymptomatic cutaneous lesions accompanied by fever and fatigue. Dermatological evaluation revealed an erythematous, crusted, large plaque on the neck with the 'apple jelly' sign on diascopy and two smaller scaly elements on the trunk and left palm. Bacteriological examinations for bacteria and mycobacteria gave negative results. Histology revealed psoriasiform epidermal hyperplasia and dermal lymphoplasmacytic infiltrate. Serology for syphilis was positive, and immunohistochemistry confirmed the presence of Treponema pallidum in lesional skin. A diagnosis of secondary syphilis was made, and the patient was successfully treated with benzathine penicillin G. Cutaneous manifestations of secondary syphilis are protean and skin tuberculosis may be considered in the differential diagnosis, especially in HIV-infected patients. In the current case, clinical examination, and particularly, 'apple jelly' sign positivity, was suggestive of lupus vulgaris, but only typical histopathology and immunohistochemistry led to the correct diagnosis of secondary syphilis.

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“…2 Eosinophil-rich syphilis is also described in literature, but this find is rare. 3–10 Considering that, we report an uncommon oral eosinophils-rich secondary syphilis.…”

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confidence: 81%