Sífilis maligna en paciente infectado por el virus de la inmunodeficiencia humana (VIH)

Fernández‐Guarino, M.; Mora, Isabel; García, Carmen Isabel Gómez; Castaño, A. Harto; Izquierdo, R. Moreno; Olásolo, Pedro Jaén

doi:10.1016/s0001-7310(06)73428-7

Cited by 19 publications

(2 citation statements)

References 9 publications

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“…Secondary syphilis has been termed the “great masquerader”, because its skin lesions show such diverse clinical and/or histologic morphologies, mimicking alopecia areata (130), bullous pemphigoid (131), cutaneous lymphoid hyperplasia (pseudolymphoma) (132–135), erythema multiforme (126, 136), granuloma annulare (43, 128, 137, 138), histiocytoma (34), leprosy (128, 139, 140), lichen planus (34, 126, 135, 141, 142), lupus erythematosus (43, 128, 143), mycosis fungoides (126, 144–146), pemphigus vulgaris (147), pityriasis lichenoides et varioliformis acuta (PLEVA) (34, 126, 135), pruritic (eczematous) dermatoses (126, 128, 148), psoriasis (34, 128, 149, 150), pustular psoriasis (34, 128), sarcoidosis (34, 135, 151–155), small vessel vasculitis (156), suppurative folliculitis (157), superficial thrombophlebitis (158), Sweet’s syndrome (128, 159), tinea imbricata and erythema annulare centrifugum (34, 160), and urticaria (104). Ulcerative nodular presentations are rare and can occur secondary to follicular pustules (157, 161), or an obliterative endarteritis, known as lues maligna (162, 163). Lues maligna appears to be more common when HIV co-infection is present (162–166).…”

Section: The Pathology Of Human Syphilismentioning

confidence: 99%

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The Immunopathobiology of Syphilis: The Manifestations and Course of Syphilis Are Determined by the Level of Delayed-Type Hypersensitivity

Carlson

Dabiri²,

Cribier³

et al. 2011

The American Journal of Dermatopathology

166

136

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Syphilis has plagued mankind for centuries and is currently resurgent in the Western hemisphere. While there has been a significant reduction of tertiary disease, and recognition of facilitative interactions with HIV infection, the natural history of syphilis has remained largely unchanged; thus, new strategies are required to more effectively combat this pathogen. The immunopathologic features of experimental syphilis in the rabbit; the course, stages, and pathology of human syphilis; and a comparison of human syphilis with leprosy suggest that the clinical course of syphilis and its tissue manifestations are determined by the balance between delayed type hypersensitivity (DTH) and humoral immunity to the causative agent, Treponema pallidum. A strong DTH response is associated with clearance of the infecting organisms in a well-developed chancre, whereas a cytotoxic T-cell response or strong humoral antibody response is associated with prolonged infection and progression to tertiary disease. Many of the protean symptoms/appearances of secondary and tertiary human syphilis are manifestations of immune reactions that fail to clear the organism, due to a lack of recruitment and more importantly, activation of macrophages by sensitized CD4 T-cells. The Bacillus Calmette Guerin (BCG) vaccination can enhance DTH and has been shown to produce a low, but measurable beneficial effect in the prevention of leprosy, a disease that shows a disease spectrum with characteristics in common with syphilis. In the prevention of syphilis, a potential vaccine protective against syphilis should be designed to augment the DTH response.

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Section: The Pathology Of Human Syphilismentioning

confidence: 99%

“…Ulcerative nodular presentations are rare and can occur secondary to follicular pustules (157, 161), or an obliterative endarteritis, known as lues maligna (162, 163). Lues maligna appears to be more common when HIV co-infection is present (162–166). …”

Section: The Pathology Of Human Syphilismentioning

confidence: 99%

The Immunopathobiology of Syphilis: The Manifestations and Course of Syphilis Are Determined by the Level of Delayed-Type Hypersensitivity

Carlson

Dabiri²,

Cribier³

et al. 2011

The American Journal of Dermatopathology

166

136

View full text Add to dashboard Cite

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Die ungewöhnlichen Gesichter der Syphilis

et al. 2011

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The challenging "great masquerader" is resurgent! For several years syphilis has shown an increasing incidence across Europe and its variable manifestations necessitate its inclusion amongst many differential diagnoses. Using serological tests, it is possible to accurately diagnose syphilis, initiate stage-appropriate therapy and exclude co-infections. In this article, we feature nine unusual presentations of secondary syphilis. In four cases, serology confirmed HIV co-infection.

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Malignant syphilis in an AIDS patient

et al. 2014

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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.

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Sífilis maligna en paciente infectado por el virus de la inmunodeficiencia humana (VIH)

Cited by 19 publications

References 9 publications

The Immunopathobiology of Syphilis: The Manifestations and Course of Syphilis Are Determined by the Level of Delayed-Type Hypersensitivity

The Immunopathobiology of Syphilis: The Manifestations and Course of Syphilis Are Determined by the Level of Delayed-Type Hypersensitivity

Die ungewöhnlichen Gesichter der Syphilis

Malignant syphilis in an AIDS patient

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