1
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Jimenez D, Rabe MS, Agarwal AN, Dalton SR, Anstead GM. An Exuberant Case of Ulceronodular-Rupioid (Malignant) Syphilis in an HIV Patient: A Proposal for New Diagnostic Criteria. Infect Dis Rep 2024; 16:499-518. [PMID: 38920894 PMCID: PMC11203149 DOI: 10.3390/idr16030038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/25/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
We report the case of a 28-year-old male with uncontrolled human immunodeficiency virus (HIV) infection who presented with extensive ulcerated lesions with dark lamellated crusting on his face, torso, and limbs. The patient had a rapid plasma reagin (RPR) titer of 1:512, indicative of syphilis. A skin biopsy revealed granulomata surrounded by lymphocytes, histiocytes, and plasma cells, with spirochetes visible on immunohistochemical staining. The patient's rash resolved with hyperpigmented scarring after penicillin and doxycycline treatment. This severe form of secondary syphilis has been termed malignant syphilis, lues maligna, ulceronodular syphilis, or rupioid syphilis. We propose a single descriptive name for this entity, ulceronodular-rupioid syphilis. In 1969, Fisher proposed criteria for malignant syphilis based on lesion appearance, histopathologic findings, high RPR values, and rapid response to treatment. We found that the Fisher criteria were imprecise with respect to specific histopathologic findings, the quantitation of RPR values, and what constitutes rapid response to treatment. Thus, we examined an additional 74 cases from the literature and propose new diagnostic criteria based on rash appearance, histopathologic characteristics, non-treponemal and treponemal test positivity, and response to therapy. We also found that uncontrolled viremia, and not a low CD4 count, is a major risk factor for ulceronodular-rupioid syphilis in HIV patients.
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Affiliation(s)
- Dennys Jimenez
- Department of Medicine, Division of Infectious Diseases, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA;
| | - Marian Santillan Rabe
- Family-Focused AIDS Clinical Treatment Services Clinic, University Health System, 903 W. Martin St., San Antonio, TX 78207, USA;
| | - Apeksha N. Agarwal
- Department of Pathology, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA;
| | - Scott R. Dalton
- Sagis Diagnostics, PLLC, 4131 Directors Row, Houston, TX 77092, USA;
| | - Gregory M. Anstead
- Department of Medicine, Division of Infectious Diseases, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA;
- Family-Focused AIDS Clinical Treatment Services Clinic, University Health System, 903 W. Martin St., San Antonio, TX 78207, USA;
- Medical Service, Division of Infectious Diseases, South Texas Veterans Healthcare System, 7400 Merton Minter Blvd., San Antonio, TX 78229, USA
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2
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Khalil S, Donthi D, Gru AA. Cutaneous Reactive B-cell Lymphoid Proliferations. J Cutan Pathol 2022; 49:898-916. [PMID: 35656820 DOI: 10.1111/cup.14264] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/14/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
Cutaneous lymphoid hyperplasia (CLH), also known as cutaneous pseudolymphoma, is a spectrum of benign conditions characterized by reactive B- and T-cell cutaneous lymphocytic infiltrates. B-cell lymphoid proliferations are a heterogenous group of non-neoplastic cutaneous diseases that must be histopathologically distinguished from cutaneous B-cell lymphomas. These proliferations can be observed as reactive phenomena to infections, medications, allergens, neoplasms, and more. Further, there are many inflammatory conditions that present with reactive B-cell infiltrates, including actinic prurigo, Zoon balanitis, Rosai-Dorfman, and cutaneous plasmacytosis. This review summarizes multiple cutaneous B-cell lymphoid proliferations within the major categories of reactive and disease-associated CLH. Further we discuss major discriminating features of atypical CLH and malignancy. Understanding the specific patterns of B-cell CLH is essential for the proper diagnosis and treatment of patients presenting with such lesions.
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Affiliation(s)
- Shadi Khalil
- Department of Dermatology, University of California San Diego
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3
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Nethers K, Mojica RE, Marks E, Burger R, Saeed S, Steffes W. A case of secondary syphilis masquerading as cutaneous lymphoma. JAAD Case Rep 2021; 14:17-20. [PMID: 34258344 PMCID: PMC8253886 DOI: 10.1016/j.jdcr.2021.05.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kevin Nethers
- Kansas City University-Graduate Medical Education Consortium/Advanced Dermatology and Cosmetic Surgery Orlando Dermatology Residency Program, Oviedo, Florida
| | - Rafael E Mojica
- Edward Via College of Osteopathic Medicine, Department of Graduate Medical Education, Spartanburg, South Carolina
| | - Etan Marks
- Kansas City University-Graduate Medical Education Consortium/Advanced Dermatology and Cosmetic Surgery Orlando Dermatology Residency Program, Oviedo, Florida.,Advanced Dermatology and Cosmetic Surgery, Department of Graduate Medical Education, Maitland, Florida
| | - Robin Burger
- Kansas City University-Graduate Medical Education Consortium/Advanced Dermatology and Cosmetic Surgery Orlando Dermatology Residency Program, Oviedo, Florida.,Advanced Dermatology and Cosmetic Surgery, Department of Graduate Medical Education, Maitland, Florida
| | - Sadia Saeed
- Kansas City University-Graduate Medical Education Consortium/Advanced Dermatology and Cosmetic Surgery Orlando Dermatology Residency Program, Oviedo, Florida.,Advanced Dermatology and Cosmetic Surgery, Department of Graduate Medical Education, Maitland, Florida
| | - William Steffes
- Kansas City University-Graduate Medical Education Consortium/Advanced Dermatology and Cosmetic Surgery Orlando Dermatology Residency Program, Oviedo, Florida.,Advanced Dermatology and Cosmetic Surgery, Department of Graduate Medical Education, Maitland, Florida
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4
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Wibisono O, Idrus I, Djawad K. Malignant Syphilis: A Systematic Review of the Case Reports Published in 2014-2018. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:S1578-2190(21)00174-8. [PMID: 34052138 DOI: 10.1016/j.adengl.2021.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/13/2021] [Indexed: 01/06/2023] Open
Abstract
Malignant syphilis (MS) is a rare manifestation of secondary syphilis which mainly occurs in immunocompromised individuals such as those coinfected with human immunodeficiency virus (HIV). However, recent reports have described MS in immunocompetent individuals. To describe the characteristics of individuals with MS and associated risk factors, a review of case reports published from 2014 to 2018 was conducted. Out of 45 published case reports, 33 cases (73%) occurred in HIV-positive individuals with majority having CD4 counts <500 cells/mm3. Of the 12 cases (27%) in HIV-negative individuals, half had comorbidities such as diabetes mellitus, alcoholism, drug abuse, psoriasis, and hepatitis. The most frequent manifestation of MS was ulceronodular cutaneous lesions with central adherent crust, which affected the face, trunk, and limbs. Given the increasing number of MS regardless of the immune status, dermatologists and general practitioners should be vigilant to allow early diagnosis and treatment, hence reducing their morbidity.
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Affiliation(s)
- O Wibisono
- Servicio de Dermatología y Venereología, Facultad de Medicina de la Universidad de Hasanuddin, Makassar, Indonesia; Hospital Dr. Wahidin Sudirohusodo, Makassar, Indonesia.
| | - I Idrus
- Servicio de Dermatología y Venereología, Facultad de Medicina de la Universidad de Hasanuddin, Makassar, Indonesia
| | - K Djawad
- Servicio de Dermatología y Venereología, Facultad de Medicina de la Universidad de Hasanuddin, Makassar, Indonesia; Hospital Dr. Wahidin Sudirohusodo, Makassar, Indonesia
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5
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Wibisono O, Idrus I, Djawad K. Malignant Syphilis: A Systematic Review of the Case Reports Published in 2014-2018. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:S0001-7310(21)00135-6. [PMID: 33811833 DOI: 10.1016/j.ad.2021.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/26/2021] [Accepted: 02/13/2021] [Indexed: 01/01/2023] Open
Abstract
Malignant syphilis (MS) is a rare manifestation of secondary syphilis which mainly occurs in immunocompromised individuals such as those coinfected with human immunodeficiency virus (HIV). However, recent reports have described MS in immunocompetent individuals. To describe the characteristics of individuals with MS and associated risk factors, a review of case reports published from 2014 to 2018 was conducted. Out of 45 published case reports, 33 cases (73%) occurred in HIV-positive individuals with majority having CD4 counts < 500 cells/mm3. Of the 12 cases (27%) in HIV-negative individuals, half had comorbidities such as diabetes mellitus, alcoholism, drug abuse, psoriasis, and hepatitis. The most frequent manifestation of MS was ulceronodular cutaneous lesions with central adherent crust, which affected the face, trunk, and limbs. Given the increasing number of MS regardless of the immune status, dermatologists and general practitioners should be vigilant to allow early diagnosis and treatment, hence reducing their morbidity.
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Affiliation(s)
- O Wibisono
- Servicio de Dermatología y Venereología, Facultad de Medicina de la Universidad de Hasanuddin, Makassar, Indonesia; Hospital Dr. Wahidin Sudirohusodo, Makassar, Indonesia.
| | - I Idrus
- Servicio de Dermatología y Venereología, Facultad de Medicina de la Universidad de Hasanuddin, Makassar, Indonesia
| | - K Djawad
- Servicio de Dermatología y Venereología, Facultad de Medicina de la Universidad de Hasanuddin, Makassar, Indonesia; Hospital Dr. Wahidin Sudirohusodo, Makassar, Indonesia
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6
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Xia W, Zhao J, Su B, Jiao Y, Weng W, Zhang M, Wang X, Guo C, Wu H, Zhang T, Gao Y, Li Z. Syphilitic infection impairs immunity by inducing both apoptosis and pyroptosis of CD4 + and CD8 + T lymphocytes. Innate Immun 2020; 27:99-106. [PMID: 32873094 PMCID: PMC7780356 DOI: 10.1177/1753425920952840] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Syphilis is an important health problem worldwide; however, few studies have probed the impact of syphilitic infection on T cell turnover. The mechanisms behind the frequency of T cell subset changes and the associations between these subsets during syphilitic infection remain unclear. Herein, we used a cell-staining method and flow cytometry to explore changes in T cell subpopulations and potential contribution of apoptosis and pyroptosis that triggered therein. We investigated caspase-1-mediated pyroptosis and caspase-3-mediated apoptosis of CD4+ and CD8+ T cells, the major effector lymphocytes with pivotal roles in the pathogenesis of infectious diseases. We found that the levels of caspase-1 and caspase-3 increased in both the circulation and intracellularly in CD4+ and CD8+ T cells. Caspase-1 showed a continual increase from early latent stage infection through to phase 2 disease, whereas caspase-3 increased through to phase 1 disease but declined during phase 2. In addition, serum levels and intracellular expression of caspase-1 and caspase-3 were positively correlated. Overall, this study increases our understanding of how syphilitic infection influences CD4+ and CD8+ T-cell turnover, which may help with designing novel and effective strategies to control syphilis infection and prevent its transmission.
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Affiliation(s)
- Wei Xia
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Jinxue Zhao
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, The First Hospital of Fangshan District, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Yanmei Jiao
- Treatment and Research Center for Infectious Diseases, the Fifth Medical Center of the General Hospital of PLA, China *Wei Xia and Jinxue Zhao contributed equally to the article
| | - Wenjia Weng
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China
| | - Ming Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China
| | - Xiaodan Wang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China
| | - Caiping Guo
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Yanqing Gao
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China
| | - Zaicun Li
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China
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7
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Diagnosis and Management of Syphilis in Patients With HIV Co-infection. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2020. [DOI: 10.1007/s40506-020-00225-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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8
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Pallazola VA, Deib G, Abha S, Geha RM, Kobayashi K. An Elusive Case of Mycosis Fungoides: Case Report and Review of the Literature. J Gen Intern Med 2019; 34:2669-2674. [PMID: 31388911 PMCID: PMC6848709 DOI: 10.1007/s11606-019-05231-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 04/30/2019] [Accepted: 07/09/2019] [Indexed: 11/26/2022]
Abstract
Erythroderma refers to a spectrum of skin diseases resulting in diffuse erythema and scaling encompassing ≥ 90% of the body surface area. The differential diagnosis ranges from primary dermatologic diseases such as atopic dermatitis and psoriasis to potentially deadly causes such as staphylococcal toxic shock syndrome, toxic epidermal necrolysis, and malignancy. Cutaneous T cell lymphoma (CTCL) is an uncommon but highly morbid cause of erythroderma. This non-Hodgkin lymphoma remains a diagnostic challenge due to its variable clinical presentation and varied histologic features. Mycosis fungoides (MF) is the most common form of CTCL. Making a timely diagnosis is challenging as it may mimic inflammatory diseases of the skin including eczema, psoriasis, lichen planus, and cutaneous lupus. We present a case of a 58-year-old man who presented with 5 years of cutaneous symptoms and several months of fevers and night sweats, ultimately diagnosed as MF. Owing to diffuse CD30 positivity, he was a candidate for brentuximab vedotin, an antibody-drug conjugate medication that selectively targets the CD30 antigen. This resulted in an excellent therapeutic response.
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Affiliation(s)
- Vincent A Pallazola
- Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
| | - Gerard Deib
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Soni Abha
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rabih M Geha
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Medical Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Kimiyoshi Kobayashi
- Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
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9
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Mitteldorf C, Kempf W. Cutaneous pseudolymphoma—A review on the spectrum and a proposal for a new classification. J Cutan Pathol 2019; 47:76-97. [DOI: 10.1111/cup.13532] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 05/26/2019] [Accepted: 06/14/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Christina Mitteldorf
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center Göttingen Germany
| | - Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik Zürich Switzerland
- Department of DermatologyUniversity Hospital Zurich Zurich Switzerland
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10
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Chelidze K, Thomas C, Chang AY, Freeman EE. HIV-Related Skin Disease in the Era of Antiretroviral Therapy: Recognition and Management. Am J Clin Dermatol 2019; 20:423-442. [PMID: 30806959 PMCID: PMC6581453 DOI: 10.1007/s40257-019-00422-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Antiretroviral therapy (ART) has revolutionized the treatment and prognosis of people living with HIV (PLHIV). With increased survival and improved overall health, PLHIV are experiencing dermatologic issues both specific to HIV and common to the general population. In this new era of ART, it is crucial for dermatologists to have a strong understanding of the broad range of cutaneous disease and treatment options in this unique population. In this review, we outline the most common skin diseases in PLHIV, including HIV-associated malignancies, inflammatory conditions, and infections, and focus on the role of ART in altering epidemiology, clinical features, diagnosis, and treatment of cutaneous conditions.
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Affiliation(s)
- Khatiya Chelidze
- Weill Cornell Medical College, Massachusetts General Hospital, 1300 York Avenue, New York, NY, 10021, USA
| | - Cristina Thomas
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Bartlett Hall 6R, Boston, MA, 02114, USA
| | - Aileen Yenting Chang
- Department of Dermatology, University of California, San Francisco, 505 Paranassus Avenue, San Francisco, CA, 94143, USA
| | - Esther Ellen Freeman
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Bartlett Hall 6R, Boston, MA, 02114, USA.
- Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
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11
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Li Y, Wang X, Li Y, Ma R, Zhao Z, Ren J, Men J. Early changes in gene expression of the entire pathological process in Cutaneous T-cell lymphoma. J Cell Biochem 2019; 120:17472-17480. [PMID: 31106473 DOI: 10.1002/jcb.29011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 04/13/2019] [Accepted: 04/18/2019] [Indexed: 11/08/2022]
Abstract
In this study, we aimed to explore the time-course relating to the pathological progression of Cutaneous T-cell lymphoma (CTCL) and to identify the early changes in gene expression. The raw microarray data of CTCL was downloaded from the Gene Expression Omnibus database and a weighted gene coexpression network analysis was performed. A total of 2183 genes that positively correlated with the time course of CTCL development were identified in as part of the turquoise module as well as 1096 genes negatively correlated with the time course of CTCL development, which was identified in the blue module. To better understand the effects of these genes on prognosis, we further performed the Spearman correlation analysis, univariate Cox regression analysis, and Kaplan-Meier survival analysis. We identified 10 differentially expressed genes whose expression was significantly associated with prognosis in patients with CTCL. Our findings can help our understanding of the underlying mechanisms of CTCL as well as the development of novel drugs.
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Affiliation(s)
- Yang Li
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Wang
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Yonggang Li
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Rui Ma
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Zilong Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Ren
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Jianlong Men
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
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12
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Mitteldorf C, Plumbaum H, Zutt M, Schön MP, Kaune KM. CD8‐positive pseudolymphoma in lues maligna and human immunodeficiency virus with monoclonal T‐cell receptor‐beta rearrangement. J Cutan Pathol 2018; 46:204-210. [DOI: 10.1111/cup.13390] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/27/2018] [Accepted: 11/05/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Christina Mitteldorf
- Department of Dermatology, Venereology and AllergologyUniversity Medical Centre Göttingen Göttingen Germany
| | - Heidi Plumbaum
- Department of PathologyKlinikum Bremen‐Mitte Bremen Germany
| | - Markus Zutt
- Department of Dermatology and AllergologyKlinikum Bremen‐Mitte Bremen Germany
| | - Michael P. Schön
- Department of Dermatology, Venereology and AllergologyUniversity Medical Centre Göttingen Göttingen Germany
| | - Kjell M. Kaune
- Department of Dermatology and AllergologyKlinikum Bremen‐Mitte Bremen Germany
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13
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Pradhan S, Sirka CS, Panda M, Baisakh M. Lues Maligna in an Immunocompetent Female. Indian Dermatol Online J 2018; 9:344-346. [PMID: 30258808 PMCID: PMC6137667 DOI: 10.4103/idoj.idoj_277_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Swetalina Pradhan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Chandra S Sirka
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Maitreyee Panda
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Manas Baisakh
- Department of Pathology, Prolife Diagnostics, Bhubaneswar, Odisha, India
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14
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Butler C, Skelton WP, Patel A, Mahtta D, Zhuang Y, Cherabuddi K, Shah K, Markham M. Peripheral T-cell lymphoma mimicking classic Hodgkin's lymphoma in a patient presenting with fevers of unknown origin. BMJ Case Rep 2018; 2018:bcr-2017-220858. [PMID: 29420242 DOI: 10.1136/bcr-2017-220858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 52-year-old man presented to our hospital for further workup of fever of unknown origin after an extensive workup at an outside hospital had failed to reveal a diagnosis. At the outside hospital, he underwent excisional biopsy of the left supraclavicular lymph node, which showed non-necrotising granulomatous changes, and a bone marrow biopsy which showed a normocellular marrow. He was discharged without a diagnosis with recommendations to present to a tertiary hospital. During his admission, his hospital course was complicated by new direct hyperbilirubinaemia and eosinophilia, prompting liver and skin biopsies which showed CD30+ and CD3+ cells. He subsequently underwent left axillary lymph node biopsy, which was reported as 'classic Hodgkin's lymphoma'. With worsening lab values and T cells noted on liver and skin biopsies, excisional lymph node biopsy was sent to the National Institute of Health, where it was confirmed patient had peripheral T cell lymphoma.
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Affiliation(s)
- Caitlin Butler
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | | | - Arpan Patel
- Division of Hematology/Oncology, Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Dhruv Mahtta
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Yi Zhuang
- Department of Pathology, University of Florida, Gainesville, Florida, USA
| | - Kartik Cherabuddi
- Division of Infectious Disease and Global Medicine, Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Kairav Shah
- Division of Infectious Disease and Global Medicine, Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Merry Markham
- Division of Hematology/Oncology, Department of Medicine, University of Florida, Gainesville, Florida, USA
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15
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Matsutaka Y, Koyano J, Hidaka Y. Perceptions of Reducing HIV-Preventive Behaviors among Men Who Have Sex with Men Living with HIV in Japan. Health (London) 2018. [DOI: 10.4236/health.2018.1012130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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Cerchione C, Maraolo AE, Marano L, Pugliese N, Nappi D, Tosone G, Cimmino I, Cozzolino I, Martinelli V, Pane F, Picardi M. Secondary syphilis mimicking malignancy: A case report and review of literature. J Infect Chemother 2017; 23:576-578. [PMID: 28456488 DOI: 10.1016/j.jiac.2017.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/27/2017] [Accepted: 03/08/2017] [Indexed: 11/30/2022]
Abstract
A 56-year-old man developed disseminate lymphadenopathies, associated with hepato-splenomegaly, fever, nocturnal sweating and weight loss. Imaging studies in particular FDG-PET/CT raised the suspicion of a malignant disease. But blood flow cytometry assay for B/T cell clonality was negative and fine-needle biopsy of enlarged laterocervical lymph node showed a not specific "reactive hyperplasia". Four months later, the patient developed a non-itching rash; since a further anamnestic investigation revealed an history of high-risk sexual intercourse, the patient underwent serological tests for Treponema pallidum that were positive at high titer, after a first negative screening. Made the diagnosis of secondary syphilis, the patient responded to the treatment with benzyl penicillin with complete resolution of symptoms. This case highlights the importance of carefully screening the patients with suspected lymphoadenopathies also for lue, particularly in presence of behavioral risk factors.
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Affiliation(s)
- Claudio Cerchione
- Department of Clinical Medicine and Surgery - Hematology, University of Naples "Federico II", Italy.
| | - Alberto Enrico Maraolo
- Department of Clinical Medicine and Surgery - Section of Infectious Diseases, University of Naples "Federico II", Italy
| | - Luana Marano
- Department of Clinical Medicine and Surgery - Hematology, University of Naples "Federico II", Italy
| | - Novella Pugliese
- Department of Clinical Medicine and Surgery - Hematology, University of Naples "Federico II", Italy
| | - Davide Nappi
- Department of Clinical Medicine and Surgery - Hematology, University of Naples "Federico II", Italy
| | - Grazia Tosone
- Department of Clinical Medicine and Surgery - Section of Infectious Diseases, University of Naples "Federico II", Italy
| | - Ilaria Cimmino
- Department of Translational Medical Sciences, University of Naples "Federico II", Italy
| | - Imma Cozzolino
- Department of Translational Medical Sciences, University of Naples "Federico II", Italy
| | - Vincenzo Martinelli
- Department of Clinical Medicine and Surgery - Hematology, University of Naples "Federico II", Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery - Hematology, University of Naples "Federico II", Italy
| | - Marco Picardi
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Italy
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