Secondary syphilis in a 15-year old male

ABSTRACT

We report a case of a 15 year-old male who presented with multiple erythematous,non-tender, annular plaques on the penis, scrotal area, face, scalp, hands and feet and a reactive RPR test. Biopsy revealed a marked irregular psoriasiform hyperplasia of the stratum malphigii and permeation of the epidermis with neutrophils and lymphocytes. The dermis shows a moderately dense lichenoid or band-like inflammatory infiltration consisting of innumerable plasma cells, histiocytes, neutrophils and some lymphocytes. There is also noted mild superficial and deep perivascular as well as periappendageal inflammatory infiltration. The inflammatory cells around the appendages consist if plasma cells, histiocytes and few lymphocytes. The blood vessels are shown to have endothelial cells swelling with mild extravasated red blood cells. The diagnosis was secondary syphilis. The patient was treated with a single dose of benzathine penicillin G 1.8 M units intramuscularly. Marked improvement of the lesions was noted after 1 week.