The many faces of secondary syphilis: a re-emergence of an old disease

Triumvirate Presentation and Treatment of Psoriasis in the Setting of HIV and Treponema pallidum Infection

Psoriasis is an autoimmune condition in which the immune system attacks healthy skin cells, causing the accelerated formation of new skin characterized by scaly patches or plaques. These lesions are formed due to the formation of new skin underneath dead skin that has yet to be shed. Although the cause of psoriasis is not completely understood, it has been associated with infections that may trigger or exacerbate the condition. Syphilis, a highly infectious sexually transmitted disease, may trigger a psoriasis outbreak; because syphilis is known as “the great imitator”, it can present as many other chronic dermatoses and therefore often makes it very difficult to diagnose. Here, we describe a case of a 17-year-old Vietnamese male from Dong Nai Province who was initially diagnosed with psoriasis and later diagnosed with syphilis and HIV infection upon further investigation and testing.

Oral manifestations of syphilis: an epidemiological study in southern Brazil

BACKGROUND

Syphilis is an infectious, sexually transmitted disease with varied oral manifestations, that can mimic other lesions. This study aimed to conduct an epidemiological survey of cases of syphilis, diagnosed from oral manifestations, establishing the sociodemographic profile of patients and clinical characteristics of oral lesions.

METHODS

The medical records of patients with oral lesions of syphilis acquired were reviewed, and 109 cases were selected.

RESULTS

The mean age of the patients was 34.4 years and, of these, 51% were male. In 105 cases, the disease was diagnosed in the secondary stage; in three cases, in the primary stage; and, in one case, in the tertiary stage. The cases of primary syphilis presented as single and ulcerated nodules, and the case of tertiary syphilis, as a necrotic lesion in the palate. In 86% of cases of secondary syphilis, there were multicentric lesions, presenting as grayish-white plaques (85%), associated or not with erosive and/or ulcerated lesions (33%), mostly affecting the labial mucosa and tongue. In 91.7% of cases painful symptoms were reported.

CONCLUSION

Considering the increase in syphilis, it is extremely important that dentists recognize its oral manifestations, because early diagnosis and treatment can minimize the risks of complications and transmission.

[New aspects in the histopathology of infectious skin diseases]

BACKGROUND

An infectious pathogenesis should always be considered in inflammatory infiltrates in the skin. While some organisms can be recognized on hematoxylin-eosin staining (e.g. yeasts, leishmania), histochemical and immunohistochemical stainings are available for others.

OBJECTIVES

If no organisms are seen in a section, the diagnosis of an infection cannot be made with surety, but the pattern of the inflammatory infiltrate can still be suggestive of an infectious process. New or little-known reaction patterns and difficulties in differential diagnosis will be demonstrated.

MATERIALS AND METHODS

Selective literature review and analysis of individual cases.

RESULTS

Studies using molecular techniques to identify organisms in biopsy specimens have helped to better characterize the histomorphological spectrum of skin infiltrates in infectious skin diseases. Apart from unusual herpes simplex and varicella zoster infections, the histopathology of coxsackie virus and measles exanthem, borreliosis, syphilis, and of cutaneous leishmaniasis is demonstrated. For numerous organisms, molecular tests have been established that can be used on the formalin-fixed, paraffin-embedded material.

CONCLUSIONS

Selected skin infections demonstrate the broad histomorphological spectrum of skin infiltrates induced by infectious organisms. It is important for histopathologists to know which reaction pattern requires them to alert the clinician to necessary ancillary diagnostics (culture, serology) and when to consider molecular diagnostics to be performed on the biopsy specimen.

Dermoscopic clues in the skin lesions of secondary syphilis

Secondary syphilis may have a varied clinical presentation and might pose a diagnostic difficulty when a typical history is absent. We describe the dermoscopic clues of the skin lesions at different stages of the disease which could culminate to a proper diagnosis.

Syphilis: A great imitator

Despite advances in the control, diagnosis, and treatment of syphilis, its recognition is ill- understood or often not considered by dermatologists and other physicians who either have little specialized training in the minutiae of sexually transmitted infections (STIs) or whose dermatologic practice is only occasionally consulted by individuals from communities where STIs are prevalent. Our aim is to highlight contemporary ideas and findings on syphilis so that not only is an accurate diagnosis of syphilis made and recognized treatment given, but also necessary measures, such as counseling to exclude other STIs and to prevent reinfection, partner notification, and public health epidemiology as for any other infectious disease, are not forgotten. For syphilis, like human immunodeficiency virus (HIV) infection, not only is the biomedical aspect important, but also are the social and psychologic components.

Secondary Syphilis Presenting As Palmoplantar Psoriasis

In a recent past, the incidence of syphilis has increased in various geographical regions. The authors describe a case of secondary syphilis mimicking palmoplantar psoriasis.

Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study

Syphilis is an infectious disease caused by the bacterium Treponema pallidum. Syphilis has three clinical stages and may present various oral manifestations, mainly at the secondary stage. The disease mimics other more common oral mucosa lesions, going undiagnosed and with no proper treatment. Despite the advancements in medicine toward prevention, diagnosis, and treatment syphilis remains a public health problem worldwide. In this sense, dental surgeons should be able to identify the most common manifestations of the disease in the oral cavity, pointing to the role of this professional in prevention and diagnosis. This study describes a case series of seven patients with secondary syphilis presenting different oral manifestations.

Syphilis: the renaissance of an old disease with oral implications

Syphilis is caused by Treponema pallidum an anaerobic filamentous spirochete. In recent years, striking outbreaks have occurred in USA, Canada, Russia, China and some areas of Central and Eastern Europe. Main epidemiology changes reflect sex industry, sexual promiscuity, decreasing use of barrier protection (i.e. condoms) due to false sense of security that nowadays sexually transmitted diseases are curable and lack of pertinent knowledge. Considering that the initial presentation of syphilis may be the oral cavity, it is of great relevance to include this disease in the differential diagnosis of unusual oral ulcerations and white patches. Primary syphilis is a highly infectious disease in which inappropriate treatment may be apparently curative while the patient remains highly infectious. It is then of pivotal importance that clinicians maintain a high clinical index of suspicion. At the present time, clinical-pathologic correlation together with serologic studies remain essential in establishing the diagnosis of syphilis.