Secondary syphillis. Still the great imitator

Ew, Baum; Bernhardt, Michael; Wm, Sams; Alexander, W. James; Gl, McLean

doi:10.1001/jama.249.22.3069

Cited by 15 publications

(13 citation statements)

References 7 publications

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“…S ir , The clinical features and histological patterns of secondary syphilis are very variable, and commonly mimic those of other diseases 1–3 . We report erythema multiforme (EM)‐like lesions in syphilis that manifested as targetoid lesions on the forearms, palms and soles.…”

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confidence: 93%

Erythema multiforme-like lesions in syphilis

Lee¹,

Lee²

2003

Br J Dermatol

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Cutaneous side-effects of treatment of chronic hepatitis C by interferon alfa and ribavirin SIR, In their recent study published in this journal, 1 Dereure et al. report diffuse inflammatory skin lesions in 20 patients treated with interferon alfa and ribavirin for chronic hepatitis C. Interestingly, 50% of their patients had to interrupt the antiviral treatment because of these cutaneous side-effects.In an ongoing survey, we have followed 52 patients undergoing combination treatment with peginterferon alfa and ribavirin, of whom 12 (23%) developed de novo skin lesions. In contrast to earlier reports, 2,3 but in accordance with the results of Dereure et al., our patients presented a homogeneous clinical picture, characterized by itching, xerosis and eczematous lesions. Control of the symptoms required sustained therapy with moderately potent to potent topical corticosteroids, combined with baseline emollients, throughout the combination treatment period. Upon completion of the combination therapy, skin symptoms showed complete regression. The administration of topical corticosteroids did not alter the response to antiviral treatment. In contrast to the 50% dropout rate reported by Dereure et al., none of our patients had to interrupt the antiviral combination regimen because of cutaneous side-effects.Given the efficacy of treatment by peginterferon and ribavirin for chronic hepatitis C, and the frequency of cutaneous side-effects, we wish to stress the importance of a close interdisciplinary follow-up in order to avoid premature treatment withdrawal. Prospective studies on larger series of patients undergoing combination treatment for chronic hepatitis C might be useful in order to define the benefit of preventive skin care in these patients, such as has already been shown in atopic eczema. Livedo reticularis induced by amantadine SIR, Livedo reticularis is a mottled discoloration of the skin, with a characteristic network pattern, exacerbated by cold. It may be physiological, primary (idiopathic) or secondary to vessel wall disease or intravascular obstruction. 1 We report two cases of livedo reticularis induced by amantadine, which, although being a known side-effect of this drug, has not been reported previously in the English language dermatology literature. As amantadine is becoming a more popular drug for treating Parkinson's disease, referrals to dermatology clinics because of this side-effect may become more common. Patient 1.A 66-year-old man presented with a 5-month history of a skin eruption affecting his trunk and lower limbs (Fig. 1a,b). The eruption was fixed, unchanged since first noted and asymptomatic, with no associated systemic symptoms. Parkinson's disease had been diagnosed in 1984 and the patient was under regular neurological review. Although the disease had been originally controlled with dopaminergic drugs, the patient developed troublesome dyskinesia and amantadine was started in April 2001, with good symptomatic improvement. Apart from mild depression, he was otherwise well. The medic...

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confidence: 93%

Erythema multiforme-like lesions in syphilis

Lee¹,

Lee²

2003

Br J Dermatol

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“…One month after initiation of therapy, his skin lesions resolved, leaving depressed scars on his forehead (figs. 1,2). The titres ofthe serologic tests for syphilis decreased six months later: VDRL 1:4; FTA-ABS reactive 4+; TPHA 1:2,560; and 19s (IgM)-FTA 1:80.…”

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confidence: 99%

Tumorous syphilid.

Lee

1990

Sexually Transmitted Infections

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“…When syphilis produces unusual skin lesions, the diagnosis is often delayed and this is well evidenced in our patient. A papulonodular variant of secondary syphilis sparing the palms and soles has been considered to be a rare presentation 2 . This may be responsible for the earlier clinician not considering syphilis in the differential diagnosis and missing the condylomata lata, the annular lesions on the face, the absence of nerve thickening and the sparing of the ears.…”

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confidence: 99%

“…This may be responsible for the earlier clinician not considering syphilis in the differential diagnosis and missing the condylomata lata, the annular lesions on the face, the absence of nerve thickening and the sparing of the ears. The other differential diagnoses to be considered are lymphoma, sarcoidosis, lymphomatoid papulosis, deep fungal infections, leishmaniasis, atypical mycobacteriosis, drug eruption and halodermia 2, 3 …”

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confidence: 99%