ABSTRACT
Due to diverse clinical and histopathological presentations, diagnosis of secondary syphilis can occasionally prove challenging. Variable clinical presentations of secondary syphilis in HIV disease may result in an incorrect diagnosis and an inappropriate treatment regimen. Similarly, the histology of secondary syphilitic lesions may show considerable variation, depending on the clinical morphology of the eruption. We report a case of secondary syphilis in an HIV infected patient with cutaneous palmoplantar lesions simulating palmoplantar psoriasis.
.Subject(s)
Adult , Humans , Male , HIV Infections/pathology , Psoriasis/pathology , Syphilis, Cutaneous/pathology , Anti-Bacterial Agents/therapeutic use , Biopsy , Coinfection/drug therapy , Coinfection/pathology , Diagnosis, Differential , Keratoderma, Palmoplantar/drug therapy , Keratoderma, Palmoplantar/pathology , Penicillin G Benzathine/therapeutic use , Syphilis, Cutaneous/drug therapy , Treatment OutcomeABSTRACT
Malignant syphilis is an uncommon manifestation of secondary syphilis, in which necrotic lesions may be associated with systemic signs and symptoms. Generally it occurs in an immunosuppressed patient, mainly HIV-infected, but might be observed on those who have normal immune response. Since there is an exponential increase in the number of syphilis cases, more diagnoses of malignant syphilis must be expected. We report a case in an immunocompetent female patient.
Subject(s)
Adult , Female , Humans , Immunocompetence/immunology , Skin Ulcer/pathology , Syphilis, Cutaneous/immunology , Syphilis, Cutaneous/pathology , Anti-Bacterial Agents/therapeutic use , Penicillin G Benzathine/therapeutic use , Skin Ulcer/immunology , Syphilis, Cutaneous/drug therapy , Treatment OutcomeABSTRACT
Malignant syphilis is a rare form of secondary syphilis strongly associated with human immunodeficiency virus infection (HIV). This clinical form of the disease is characterized by atypical cutaneous ulcerative and disseminated lesions and systemic compromise that can delay the final diagnosis. There are only few reports in the medical literature about malignant lues in HIV-infected patients. Malignant syphilis should be considered in the differential diagnosis in HIV-infected patients with fever and ulcerative skin lesions. Here we describe a man who developed clinical cutaneous and systemic manifestations pathologically conirmed as malignant syphilis and we performed a review of the literature.
La sífilis maligna es una forma rara de presentación de lúes secundaria asociada a la infección por el virus de la inmunodeficiencia humana (VIH). Se caracteriza por lesiones cutáneas atípicas, ulceradas, costrosas y diseminadas, asociadas con síntomas generales inespecíficos que pueden retrasar el diagnóstico correcto. Existen sólo escasas publicaciones en la literatura médica acerca de sífilis maligna en pacientes con infección por VIH. La lúes maligna debe incluirse en el diagnóstico diferencial de los pacientes con VIH que consultan por fiebre y lesiones úlcero-costrosas diseminadas. Se describe el caso de un paciente con infección por VIH que desarrolló una sífilis maligna con confirmación diagnóstica a partir de los hallazgos histopatológicos y se realiza una revisión de la literatura científica sobre el tema.
Subject(s)
Humans , Male , AIDS-Related Opportunistic Infections/pathology , Syphilis, Cutaneous/pathology , AIDS-Related Opportunistic Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Penicillin G Benzathine/therapeutic use , Severity of Illness Index , Syphilis, Cutaneous/drug therapyABSTRACT
Los condilomas planos son una manifestación frecuente del secundarismo sifilítico, no así los de localización interdigital. Se presentan cuatro pacientes con condilomas planos interdigitales y una revisión de la literatura actualizada
Condylomata lata are a frequent manifestation of secondary syphilis,not so their unusual location. Four patients with interdigital condylomata are presented as well as a review of the literature.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Syphilis, Cutaneous/pathology , Syphilis, Cutaneous/drug therapy , Foot Dermatoses/diagnosis , Foot Dermatoses/microbiology , Foot Dermatoses/pathology , Penicillin G Benzathine/therapeutic use , Syphilis/pathology , Syphilis/drug therapyABSTRACT
Descrevemos um caso de sífilis maligna em um paciente de 42 anos com infecção pelo HIV e pelo vírus da hepatite B. O paciente, com lesões cutâneas clássicas de lues maligna e VDRL positivo no soro e no líquor, teve uma resposta excelente ao tratamento com penicilina cristalina. O VDRL sérico, que no diagnóstico era de 1:64, aumentou três meses depois para 1:2.048 e diminuiu para 1:8 após 15 meses.
Subject(s)
Humans , Male , Adult , AIDS-Related Opportunistic Infections/diagnosis , Cardiolipins/analysis , Cholesterol/analysis , Penicillins/therapeutic use , Phosphatidylcholines/analysis , Syphilis, Cutaneous/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Syphilis, Cutaneous/drug therapyABSTRACT
Se reporta el caso de un paciente masculino de 29 años con SIDA, estadio C3, desde 1997, que había presentado previamente tuberculosis y sarcoma de Kaposi, que consultó con una erupción generalizada en tórax y extremidades superiores e inferiores por ocho días, incluyendo palmas de las manos y plantas de los pies. Su último recuento de linfocitos CD4 era 77 y estaba en tratamiento con nelfinavir, stavudina y lamivudina. Las lesiones empezaron en el cuello y se generalizaron, pero no ocurrieron otros síntomas asociados. Se sospechó sífilis secundaria. El VDRL fue positivo a una dilución de 1:256 y el FTA-abs fue reactivo. Recibió tratamiento con penicilina benzatina, 4.2 millones de unidades i.m. por tres semanas con resolución de sus síntomas. Se recomienda seguimiento con pruebas serológicas en todo caso similar al presentado