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Gamel M, Muller P, Schoeffler A, Bonhomme A, Patchinsky A, Ait Bel Kacem K, Martin H. Rupioid psoriasis revealing Fiessinger-Leroy-Reiter syndrome. Ann Dermatol Venereol 2023; 150:155-157. [PMID: 36670028 DOI: 10.1016/j.annder.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/07/2022] [Accepted: 11/08/2022] [Indexed: 01/20/2023]
Affiliation(s)
- M Gamel
- Dermatology Department, Metz-Thionville Regional Hospital, Thionville, France.
| | - P Muller
- Dermatology Department, Metz-Thionville Regional Hospital, Thionville, France
| | - A Schoeffler
- Dermatology Department, Metz-Thionville Regional Hospital, Thionville, France
| | - A Bonhomme
- Dermatology Department, Metz-Thionville Regional Hospital, Thionville, France
| | - A Patchinsky
- Dermatology Department, Metz-Thionville Regional Hospital, Thionville, France
| | - K Ait Bel Kacem
- Dermatology Department, Metz-Thionville Regional Hospital, Thionville, France
| | - H Martin
- Dermatology Department, Metz-Thionville Regional Hospital, Thionville, France
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Traczuk A, Chetrit DA, Balasubramanya R, Nwaoduah N, Lee JB, Spacek LA, Loizidis G. Musculoskeletal manifestations of syphilis in adults: secondary syphilis presenting with ankle inflammatory arthritis and bone involvement with calvarial and sternal lesions. What the rheumatologist needs to know. Clin Rheumatol 2023; 42:1195-1203. [PMID: 36454341 DOI: 10.1007/s10067-022-06458-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
Although the incidence of syphilis reached a historic low in 2000, the number of incident cases has since increased in men and women across the USA. In 2019, men who have sex with men (MSM) accounted for 57% of all primary and secondary (P&S) syphilis cases, and about half of MSM with P&S syphilis are living with human immunodeficiency virus (HIV) infection. Days after infection, Treponema pallidum disseminates and invades tissues distant from the site of inoculation. Once the spirochete disseminates, the host develops an inflammatory response; diagnosis requires a high level of suspicion since syphilis may affect the skin, musculoskeletal, cardiovascular, and central nervous systems. We report a 61-year-old man with virally suppressed HIV infection who presented with polyarthralgia, chest pain, and weight loss, diagnosed with secondary syphilis, manifesting with ankle inflammatory arthritis and bone involvement, of the calvarium and manubrium. Early and late syphilis in adults can manifest with articular and periarticular pathologies, including inflammatory arthritis, tenosynovitis, periostitis, and myositis. Higher clinical suspicion is needed for prompt diagnosis of syphilis in patients who are at risk and suspected of having an autoimmune disease. This report includes a review of the musculoskeletal manifestations of syphilis.
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Affiliation(s)
- Ashley Traczuk
- Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - David Alexandre Chetrit
- Department of Medicine, Division of Rheumatology, University of California, Los Angeles, CA, USA
| | - Rashmi Balasubramanya
- Department of Radiology, Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Nneamaka Nwaoduah
- Department of Pathology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jason B Lee
- Department of Dermatology & Cutaneous Biology, Thomas Jefferson University, Thomas Jefferson University, Philadelphia, PA, USA
| | - Lisa A Spacek
- Department of Medicine, Division of Infectious Diseases, Thomas Jefferson University, Philadelphia, PA, USA
| | - Giorgos Loizidis
- Department of Medicine, Division of Rheumatology, Thomas Jefferson University, 211 S 9th Street, Suite 210, Philadelphia, PA, 19107, USA.
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Karanfilian KM, Almohssen AA, Kapila R, Schwartz RA. Malignant syphilis: a new and revised definition. Int J Dermatol 2023; 62:369-375. [PMID: 36250867 DOI: 10.1111/ijd.16444] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 08/07/2022] [Accepted: 09/22/2022] [Indexed: 12/01/2022]
Abstract
Malignant syphilis is a rare, severe variant of secondary syphilis that primarily affects immunocompromised patients. Historically, the clinical presentation included a prodrome of constitutional symptoms followed by the development of characteristic skin lesions. The definition of malignant syphilis has not been updated since it was first described as only a cutaneous manifestation. In recent years, syphilis has reemerged as a major public health issue, particularly in men who have sex with men (MSM) and patients with HIV. With increasing rates of syphilis in the HIV-positive population, the systemic manifestations of malignant syphilis have become more apparent. We propose a revised definition and elucidate why the term malignant syphilis should be expanded to include systemic manifestations, stressing musculoskeletal, central nervous system, ocular, ear, cardiovascular, rectal, liver, lung, and renal involvement. This updated definition is dramatically expanded to reflect its systemic manifestations. Recognition of these manifestations may prevent devastating long-term effects.
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Affiliation(s)
| | | | - Rajendra Kapila
- Infectious Disease, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Robert A Schwartz
- Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, NJ, USA
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Timerman D, Antonov NK, Husain S, Gallitano SM. Hyperkeratotic plaques resembling an oyster shell. JAAD Case Rep 2019; 5:653-655. [PMID: 31388530 PMCID: PMC6677915 DOI: 10.1016/j.jdcr.2019.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Kouassi Djaha JM, Maisonneuve L, de Bandt M. Syphilis, a curable cause of acute polyarthritis. Scand J Rheumatol Suppl 2016; 45:336-7. [DOI: 10.3109/03009742.2015.1111411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- JM Kouassi Djaha
- Department of Rheumatology, Robert Ballanger Hospital, Aulnay sous Bois, France
| | - L Maisonneuve
- Department of Medical Biology, Robert Ballanger Hospital, Aulnay sous Bois, France
| | - M de Bandt
- Department of Rheumatology, Robert Ballanger Hospital, Aulnay sous Bois, France
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