Two Cases of Psoriasiform Syphilid / 대한피부과학회지

ABSTRACT

The clinical feature of secondary syphilis is of `the great imitator'. The rarity of clinical syphilis today has led to an erosion of clinical skills to determine this condition. It is important for physicians to keep in mind that any atypical skin lesions may be syphilid. We report two cases of psoriasiform syphilid in a 64-year-old man and a 45-year-old woman. They presented with multiple, erythematous to brown colored scaly papules and plaques on the abdomen, back and chest. The differential diagnosis included papulosquamous diseases, especially psoriasis. Histopathologic findings were not consistent with that of psoriasis, but consisted rather with that of interface dermatitis. Serum VDRLs were strongly positive (1: 256 and 1: 64, respectively), and TPHAs were positive, too. After intramuscular treatment with 2.4 million units of benzathine penicillin G, the skin lesions cleared within 1 month.