A Case of Syphilid with Nail Dystrophy / 대한피부과학회지

ABSTRACT

Syphilis, the "great imitator" of skin diseases, is a chronic systemic infectious disease with a waxing and waning course. Clinical manifestations of syphilis are variable in appearance and have been described for centuries. Especially, secondary syphilis is characterized by large diversity of presentation. They include macular, papular, papulosquamous, syphilis cornee, psoriasiform, annular en cockade, nodular, condylomata lata, malignant syphilis, mucosal lesions, loss of the hairs, and alteration of the nails. Nail involvement of syphilis includes changes on nail plate (syphilitic onychia) or periungual tissue (syphilitic paronychia). A 20-year-old man was presented with multiple erythematous broad eroded surfaced papules and macules on the scrotum and scaly exfoliated patch with erythematous swelling on the right thumb with onychodystrophy and mild tenderness on the nail. Serological screening for syphilis showed increased titer for VDRL (116) and TPHA (+). After intramuscular treatments with benzathine penicillin G, the skin lesions on the scrotum cleared within 1 month and the nail dystrophy showed slight improvement.