ABSTRACT
This case report describes 3 patients with limited cutaneous systemic sclerosis who were found to have telangiectasias affecting the vulva and the inguinal folds.
Subject(s)
Scleroderma, Systemic , Telangiectasis , Humans , Female , Telangiectasis/diagnosis , Telangiectasis/etiology , Scleroderma, Systemic/complications , Scleroderma, Systemic/diagnosis , GenitaliaSubject(s)
Papillomavirus Infections , Squamous Intraepithelial Lesions , Uterine Cervical Dysplasia , Uterine Cervical Neoplasms , Male , Humans , Female , Retrospective Studies , Uterine Cervical Dysplasia/pathology , Papillomavirus Infections/complications , Papillomavirus Infections/pathology , PapillomaviridaeABSTRACT
INTRODUCTION: Syphilis is reemerging in certain populations, such as in men who have sex with men in particular. Oral manifestations are not uncommon and can render diagnosis difficult, particularly if occurring in isolation. MATERIALS AND METHODS: We recovered clinical data for all patients receiving a diagnosis of secondary syphilis who were referred to the National Reference Center for Syphilis in Paris, France, from January 2000 to July 2019. We selected patients presenting oral symptoms only and analyzed their general characteristics, time to diagnosis, and clinical presentations. RESULTS: Secondary syphilis was diagnosed in 206 patients, 38 of whom (18%) presented oral manifestations, which were isolated in 14 patients (37%). The main oral manifestations were subacute erosive or ulcerative lesions (55%), mucous patches on the tongue (53%), and nodular (10%) and leukokeratotic lesions (5%). Mean time to diagnosis was 4.5 months, but was significantly longer for patients with isolated oral symptoms (8.8 vs 1.8 months; P = .02). CONCLUSION: Oral presentations of secondary syphilis are frequent and challenging for diagnosis, even in patients with epidemiologic risk factors. Clinicians confronted with subacute oral lesions in such patients should bear in mind the possibility of this contagious, curable, and sometimes severe disease.
Subject(s)
Delayed Diagnosis/prevention & control , Oral Ulcer/diagnosis , Syphilis/diagnosis , Treponema pallidum/isolation & purification , Adult , Biopsy , Delayed Diagnosis/statistics & numerical data , Diagnosis, Differential , Female , France , Humans , Male , Mouth Mucosa/microbiology , Mouth Mucosa/pathology , Oral Ulcer/blood , Oral Ulcer/drug therapy , Oral Ulcer/microbiology , Penicillin G Benzathine/therapeutic use , Retrospective Studies , Risk Factors , Sexual and Gender Minorities/statistics & numerical data , Syphilis/blood , Syphilis/drug therapy , Syphilis/microbiology , Syphilis Serodiagnosis , Time Factors , Tongue/microbiology , Tongue/pathology , Treponema pallidum/immunologySubject(s)
Anus Neoplasms/virology , Neoplasms, Multiple Primary/virology , Papillomavirus Infections/complications , Squamous Intraepithelial Lesions/virology , Uterine Cervical Neoplasms/virology , Vaginal Neoplasms/virology , Vulvar Neoplasms/virology , Adolescent , Adult , Aged , Anus Neoplasms/pathology , Female , Humans , Immunocompromised Host , Middle Aged , Neoplasms, Multiple Primary/pathology , Retrospective Studies , Smoking , Squamous Intraepithelial Lesions/pathology , Uterine Cervical Neoplasms/pathology , Vaginal Neoplasms/pathology , Vulvar Neoplasms/pathology , Young AdultSubject(s)
Adenoviridae Infections , Erythema Multiforme , Adenoviridae , Erythema Multiforme/diagnosis , Genitalia , Humans , Mucous MembraneABSTRACT
We have tried to elucidate the origin of phytochemical variation in trees by studying concomitantly the chemical and microsatellite variations in Santalum austrocaledonicum. Eight natural populations were sampled in the New-Caledonian archipelago, a total of 157 individuals being analyzed. The main components, as revealed by gas chromatography (GC), were alpha- and beta-santalol (as in other sandalwood species), although the level of (Z)-lanceol was particularly high. Most of the chemical variation was observed within populations (83.7%). With microsatellites, the variation between populations was more pronounced (32% of the total variation). Although the chemical variation between populations was small, we investigated the effects of genetic drift and migration by comparing the chemical- and molecular-differentiation patterns. The poor congruence between neighbor-joining trees, confirmed by the non-significant Mantel test between the molecular and chemical distance matrices (R=0.26, P=0.12), showed that genetic drift and migration are not the main evolutionary forces acting on chemical differentiation between populations. We could not find any effect of soil and rainfall conditions neither. Although the impact of drift and migration cannot be discounted in rationalizing between-population differentiation, the low variation among populations could result from a stabilizing selection caused by the same phytopathogen charge across the natural range.
