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Kidron A, Nguyen H, Nguyen H. Triumvirate Presentation and Treatment of Psoriasis in the Setting of HIV and Treponema pallidum Infection. Cureus 2022; 14:e22129. [PMID: 35308705 PMCID: PMC8920797 DOI: 10.7759/cureus.22129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/10/2022] [Indexed: 11/08/2022] Open
Abstract
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.
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Pathania YS. Biett sign: a strong indicator of secondary syphilis. Intern Med J 2021; 51:1547-1548. [PMID: 34541766 DOI: 10.1111/imj.15478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Yashdeep Singh Pathania
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
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Thums MA, Koth VS, de Figueiredo M, Cherubini K, Salum FG. Oral manifestations of syphilis: an epidemiological study in southern Brazil. Aust Dent J 2021; 66:289-294. [PMID: 33656756 DOI: 10.1111/adj.12834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 12/23/2022]
Abstract
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.
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Affiliation(s)
- M A Thums
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | - V S Koth
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maz de Figueiredo
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | - K Cherubini
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | - F G Salum
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
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Böer-Auer A. [New aspects in the histopathology of infectious skin diseases]. DER PATHOLOGE 2020; 41:344-354. [PMID: 32239323 DOI: 10.1007/s00292-020-00770-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Almut Böer-Auer
- Dermatologikum Hamburg, Stephansplatz 5, 20354, Hamburg, Deutschland. .,Klinik für Hautkrankheiten - Allgemeine Dermatologie und Venerologie, Universitätsklinikum Münster, Von-Esmarch-Straße 58, 48149, Münster, Deutschland.
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Mathur M, Acharya P, Karki A, Shah J, KC N. Dermoscopic clues in the skin lesions of secondary syphilis. Clin Case Rep 2019; 7:431-434. [PMID: 30899465 PMCID: PMC6406165 DOI: 10.1002/ccr3.1999] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 11/24/2022] Open
Abstract
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.
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Affiliation(s)
- Mahesh Mathur
- Department of DermatologyCollege of Medical SciencesBharatpurNepal
| | - Prakash Acharya
- Department of DermatologyCollege of Medical SciencesBharatpurNepal
| | - Alina Karki
- Department of DermatologyCollege of Medical SciencesBharatpurNepal
| | - Jyoti Shah
- Department of DermatologyCollege of Medical SciencesBharatpurNepal
| | - Nisha KC
- Department of DermatologyCollege of Medical SciencesBharatpurNepal
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Abstract
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.
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Affiliation(s)
- Seray Külcü Çakmak
- Department of Dermatology, Health Sciences University, Numune Hospital, Ankara, Turkey.
| | - Emine Tamer
- Department of Dermatology, Health Sciences University, Numune Hospital, Ankara, Turkey
| | - Ayşe Serap Karadağ
- Department of Dermatology, Istanbul Medeniyet University, Istanbul, Turkey
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Gianfaldoni S, Tchernev G, Wollina U, Gianfaldoni R, Lotti T. Secondary Syphilis Presenting As Palmoplantar Psoriasis. Open Access Maced J Med Sci 2017; 5:445-447. [PMID: 28785328 PMCID: PMC5535653 DOI: 10.3889/oamjms.2017.087] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 11/05/2022] Open
Abstract
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.
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Affiliation(s)
- Serena Gianfaldoni
- University G. Marconi of Rome, Dermatology and Venereology, Rome 00192, Italy
| | - Georgi Tchernev
- Medical Institute of the Ministry of Interior, Dermatology, Venereology and Dermatologic Surgery; Onkoderma, Private Clinic for Dermatologic Surgery, Dermatology and Surgery, Sofia 1606, Bulgaria
| | - Uwe Wollina
- Krankenhaus Dresden-Friedrichstadt, Department of Dermatology and Venereology, Dresden, Sachsen, Germany
| | - Roberto Gianfaldoni
- University G. Marconi of Rome, Dermatology and Venereology, Rome 00192, Italy
| | - Torello Lotti
- Univerisity G. Marconi of Rome, Dermatology and Venereology, Rome, Italy; Universitario di Ruolo, Dipartimento di Scienze Dermatologiche, Università degli Studi di Firenze, Facoltà di Medicina e Chirurgia, Dermatology, Via Vittoria Colonna 11, Rome 00186, Italy
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Seibt CE, Munerato MC. Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study. Braz J Infect Dis 2016; 20:393-8. [PMID: 27208390 PMCID: PMC9427610 DOI: 10.1016/j.bjid.2016.03.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/17/2016] [Accepted: 03/20/2016] [Indexed: 11/19/2022] Open
Abstract
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.
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Affiliation(s)
- Creta Elisa Seibt
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Odontologia, Porto Alegre, RS, Brazil
| | - Maria Cristina Munerato
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Odontologia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
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Putri I, Mercer SE, Phelps RG, Levitt JO. False-negative anti-treponemal immunohistochemistry in secondary syphilis. Int J Dermatol 2012; 52:172-6. [DOI: 10.1111/j.1365-4632.2011.05225.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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XU XG, ZHANG YQ, XIAO T, CHEN HD. Localized granulation tissue-like nodules: An unusual cutaneous presentation of secondary syphilis. J Dermatol 2011; 39:565-6. [DOI: 10.1111/j.1346-8138.2011.01435.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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An HIV-Positive Male with a Herald Plaque. Clin Infect Dis 2011. [DOI: 10.1093/cid/ciq212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Syphilis: the renaissance of an old disease with oral implications. Head Neck Pathol 2009; 3:195-206. [PMID: 20596972 PMCID: PMC2811633 DOI: 10.1007/s12105-009-0127-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Accepted: 07/02/2009] [Indexed: 10/20/2022]
Abstract
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.
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Herrero-González JE, Amer MEP, Farrés MF, Abelló AT, Barranco C, Pujol RM. Syphilitic mucous patches: the resurgence of an old classic. Int J Dermatol 2008; 47:1281-3. [DOI: 10.1111/j.1365-4632.2008.03862.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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