Syphilis associated with paretic neurosyphilis mimicking Reiter’s syndrome in HIV-infected patients

Bastos, Thales Costa; Maia, Daniela Cristina Caetano; Gomes, Nathália Matos; Menezes, Carla Kellen da Silva; Francesconi, Valeska Albuquerque; Francesconi, Fábio

doi:10.1590/abd1806-4841.20153625

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Scrotal eczema, associated with the typical manifestation of erythematous macules/papules of the palms and soles, was another atypical manifestation of SS in our series; to the best of our knowledge, this type of lesion was previously reported only in four cases, two of which were HIV-seropositive [ 51 , 52 , 53 ]. Although in our patients with scrotal eczema histopathology and immunohistochemistry for a polyclonal antibody against T. pallidum were not performed, the concomitant diagnosis of syphilis in the sexual partner in one case and personal history of several unprotected sexual intercourses in the other, together with the complete resolution of eczema after specific antibiotic therapy, suggested that these lesions were atypical manifestations of syphilis.…”

Section: Discussionmentioning

confidence: 46%

“…There are several possible mechanisms responsible for the annular shape: lesions simply form at a site and then spread radially; a lesion can have a centrifugal spread by extension along a plane in the skin; or an inflammatory process may extend along a vessel and, because the vessels are arranged in a grid-like network, the clinical result is a figurate lesion [50]. Scrotal eczema, associated with the typical manifestation of erythematous macules/papules of the palms and soles, was another atypical manifestation of SS in our series; to the best of our knowledge, this type of lesion was previously reported only in four cases, two of which were HIV-seropositive [51][52][53]. Although in our patients with scrotal eczema histopathology and immunohistochemistry for a polyclonal antibody against T. pallidum were not performed, the concomitant diagnosis of syphilis in the sexual partner in one case and personal history of several unprotected sexual intercourses in the other, together with the complete resolution of eczema after specific antibiotic therapy, suggested that these lesions were atypical manifestations of syphilis.…”

Section: Discussionmentioning

confidence: 48%

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Atypical Manifestations of Syphilis: A 10-Year Retrospective Study

Ciccarese,

Facciorusso,

Mastrolonardo

et al. 2024

JCM

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Background: The incidence of syphilis has increased in high-income countries in the past few decades, especially among men who have sex with men. In the present study, we aimed to analyze the correlations between atypical syphilis manifestations and the demographic, clinical, and laboratory features of patients and to review unusual presentations of syphilis reported in the literature. Methods: We conducted a retrospective analysis of 307 patients with syphilis diagnosed between 1 January 2013 and 31 October 2023 at the sexually transmitted infection (STI) centers of the University of Genoa and University of Foggia with both typical and atypical manifestations of disease. Results: In our series, atypical manifestations were detected in 25.8% of the patients, especially in the secondary stage of the disease. Lesions with annular morphology and lesions presenting as itchy erythematous scaly plaques with a psoriasiform appearance were the most common atypical presentations of secondary syphilis. A statistical analysis revealed that homosexual orientation, syphilis reinfection, and venereal disease research laboratory (VDRL) titers > 1:32 were correlated with atypical manifestations. Conclusions: Our study demonstrates that the spectrum of syphilis manifestations, in all the stages of the disease, is wide; atypical manifestations often pose diagnostic challenges, may delay the provision of appropriate treatment, and facilitate the spread of the infection.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 48%

Atypical Manifestations of Syphilis: A 10-Year Retrospective Study

Ciccarese,

Facciorusso,

Mastrolonardo

et al. 2024

JCM

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Annular Eroded Plaque With Honey-Colored Crusting On Scrotum

Bui,

Lee

2024

JAMA Dermatol

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Features of clinical manifestations of secondary syphilis in a HIV infected patient

Serdyukova,

Shchava

2024

Russian Journal of Skin and Venereal Diseases

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Syphilis and human immunodeficiency virus (HIV) infection are diseases of an infectious nature with a predominantly sexual route of infection. Despite the decrease in the incidence of syphilis in recent years in Russia, there is an increase in HIV infection. The combination of several infections in one patient leads to changes in clinical manifestations, which sometimes significantly complicates their diagnosis, leading to a late start of treatment. Syphilis against the background of HIV infection proceeds in stages, but usually it has a malignant, aggressive and severe course, often with the development of atypical forms and complications. The primary syphilis against the background of HIV infection is characterized by the appearance of ulcerative-necrotic character of the hard chancre, such severe complications as phagedenism and gangrenization, the frequent addition of a secondary infection, severe soreness of the hard chancre. Secondary syphilides in HIV-infected patients are characterized by the appearance of ulceration with the formation of necrotizing vasculitis, extraordinary infectiousness of the elements. The disease progresses rapidly and over a few months from the moment of infection, manifest neurosyphilis or tertiary syphilis may develop due to immunodeficiency. The authors describe the features of the manifestations of syphilis in its different periods against the background of HIV infection. A clinical case of a 35-year-old woman who was diagnosed with secondary syphilis and HIV infection is presented. The patient had numerous skin rashes, which were interpreted differently by doctors of different specialties for 2 months. The patient was diagnosed with pyoderma, "allergy", infectious exanthema, however, against the background of the treatment, there was a negative dynamics of the skin process. The authors have demonstrated the effectiveness of specific therapy: complete resolution of skin rashes.

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Syphilis associated with paretic neurosyphilis mimicking Reiter’s syndrome in HIV-infected patients

Cited by 3 publications

References 10 publications

Atypical Manifestations of Syphilis: A 10-Year Retrospective Study

Atypical Manifestations of Syphilis: A 10-Year Retrospective Study

Annular Eroded Plaque With Honey-Colored Crusting On Scrotum

Features of clinical manifestations of secondary syphilis in a HIV infected patient

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