1
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Slyk A, Hedman M, Wikström A. A Rare Case of Widely Disseminated Syphilis. Acta Derm Venereol 2024; 104:adv27983. [PMID: 38813741 PMCID: PMC11161808 DOI: 10.2340/actadv.v104.27983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/22/2024] [Indexed: 05/31/2024] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Agnieszka Slyk
- Department of Dermatology and Venereology, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Hedman
- Department of Dermatology and Venereology, Karolinska University Hospital, Stockholm, Sweden
| | - Arne Wikström
- Department of Dermatology and Venereology, Karolinska University Hospital, Stockholm, Sweden
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2
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Gan C, Mahil S, Pink A, Rodrigues M. Atopic dermatitis in skin of colour. Part 2: considerations in clinical presentation and treatment options. Clin Exp Dermatol 2023; 48:1091-1101. [PMID: 37119261 DOI: 10.1093/ced/llad162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/09/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
Recent advances in atopic dermatitis (AD) present the condition as a heterogeneous disease of distinct endotypes across ethnic groups. AD in people with skin of colour may appear psoriasiform, lichenoid, scaly or papular, with a violaceous colour and there is a higher prevalence of post-inflammatory dyspigmentation compared with affected individuals of White ethnicity. These differences in clinical presentation may limit the use of AD assessment tools in people with skin of colour, leading to the potential for misdiagnosis and underestimation of severity, particularly in relation to assessment of erythema. Recent targeted therapies for AD have been studied in multiple ethnic groups; however, ethnicity-based subgroup analysis is often not performed. Further research is required to understand whether treatment responses or safety may differ among ethnic groups.
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Affiliation(s)
- Christian Gan
- Department of Dermatology, The Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Dermatology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Satveer Mahil
- St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust and King's College London, London, UK
| | - Andrew Pink
- St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust and King's College London, London, UK
| | - Michelle Rodrigues
- Department of Dermatology, The Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Chroma Dermatology, Pigment and Skin of Colour Centre, VIC, Australia
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3
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Huang WS, Wang TY, Liu CP, Chu TP, Wang YL, Chen MJ. Perianal erythematous skin rash for 2 months. ANZ J Surg 2023; 93:1406-1407. [PMID: 36599438 DOI: 10.1111/ans.18237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Wei-Sheng Huang
- Department of Surgery, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Tao-Yeuan Wang
- Department of Pathology, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Chang-Pan Liu
- Department of Medicine, MacKay Memorial Hospital, New Taipei City, Taiwan.,Department of Medicine & Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan
| | - Tun-Pang Chu
- Department of Surgery, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Yu-Liang Wang
- Department of Surgery, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Ming-Jen Chen
- Department of Surgery, MacKay Memorial Hospital, New Taipei City, Taiwan.,Department of Medicine & Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan
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4
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Whiting C, Schwartzman G, Khachemoune A. Syphilis in Dermatology: Recognition and Management. Am J Clin Dermatol 2023; 24:287-297. [PMID: 36689103 PMCID: PMC9869822 DOI: 10.1007/s40257-022-00755-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 01/24/2023]
Abstract
The incidence of syphilis has been increasing in the USA since 2000. Notably, the coronavirus disease 2019 pandemic negatively impacted the public health efforts to contain the spread of sexually transmitted diseases including syphilis and congenital syphilis. Clinical manifestations of syphilis are predominantly mucocutaneous lesions, thus dermatologists are primed to recognize the myriad presentations of this disease. Primary syphilis is classically characterized by a painless transient chancre most often located in the genital area. Secondary syphilis typically manifests clinically as systemic symptoms in addition to a mucocutaneous eruption of which a variety of forms exist. Although less common in the era of effective penicillin treatment, late clinical manifestations of syphilis are described as well. In addition to recognition of syphilis on physical examination, several diagnostic tools may be used to confirm infection. Treponema pallidum spirochetes may be detected directly using histopathologic staining, darkfield microscopy, direct fluorescent antibody, and polymerase chain reaction assays. A table detailing the histopathologic features of syphilis is included in this article. Serologic testing, non-treponemal and treponemal tests, is the preferred method for screening and diagnosing syphilis infections. Two serologic testing algorithms exist to aid clinicians in diagnosing positive syphilis infection. Determining the correct stage of syphilis infection combines results of serologic tests, patient history, and physical examination findings. Using the current Centers for Disease Control and Prevention case definitions and treatment guidelines, a management algorithm is proposed here. Penicillin remains the pharmacological treatment of choice although specific clinical situations allow for alternative therapies. Syphilis is a reportable disease in every state and should be reported by stage according to individual state requirements. Screening recommendations are largely based upon risks encountered through sexual exposures. Likewise, sexual partner management includes evaluating and treating persons exposed to someone diagnosed with an infective stage of syphilis. Close clinical follow-up and repeat testing are recommended to ensure appropriate response to treatment. This guide will discuss the current epidemiology of syphilis and focus on practice aspects of diagnosis and management, including public health reporting.
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Affiliation(s)
- Cleo Whiting
- grid.253615.60000 0004 1936 9510School of Medicine and Health Sciences, George Washington University, Washington, DC USA
| | - Gabrielle Schwartzman
- grid.253615.60000 0004 1936 9510School of Medicine and Health Sciences, George Washington University, Washington, DC USA
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center, State University of New York Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA. .,Department of Dermatology, Veterans Health Administration, Brooklyn, NY, USA.
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5
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Narasimhan M, Lagoo M, Ramachandran R, Fernandes S. Syphilis D' Emblée: A case series of the great masquerader. J Family Med Prim Care 2022; 11:1216-1220. [PMID: 35495838 PMCID: PMC9051677 DOI: 10.4103/jfmpc.jfmpc_997_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/08/2021] [Accepted: 10/21/2021] [Indexed: 11/04/2022] Open
Abstract
Syphilis, a chronic infectious disease caused by Treponema pallidum subspecies pallidum, progresses through three arbitrary stages resulting in varied clinical manifestations. The aberrant presentation of syphilis in the secondary stage without any clinical evidence of the primary stage is referred to as syphilis d’ emblée. Here we report a series of six cases in male patients. Five out of six patients presented with multiple, non-pruritic, macular palmar, and/or plantar lesions. One patient had typical facial and perianal lesions of condyloma lata. The diagnosis was confirmed by a reactive VDRL with titers ranging from 1:16 to 1:64 and a positive Treponema pallidum hemagglutination assay (TPHA). Syphilis being a great imitator can present in different ways without a typical history of primary chancre following sexual exposure, and can mimic many dermatological disorders in its secondary stage. Unless physicians have a high index of suspicion, the diagnosis may be missed. Early identification aids in prompt initiation of therapy and prevention of disease progression to chronic stages and systemic manifestations.
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6
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Drago F, Ciccarese G, Merlo G, Trave I, Javor S, Rebora A, Parodi A. Oral and cutaneous manifestations of viral and bacterial infections: Not only COVID-19 disease. Clin Dermatol 2021; 39:384-404. [PMID: 34517997 PMCID: PMC7849469 DOI: 10.1016/j.clindermatol.2021.01.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Globalization entails several medical problems along with economic and social complications. Migrations from other continents, increasing numbers of tourists worldwide, and importation of foreign parasites (eg, Aedes albopictus) have made diseases previously unknown in Europe a reality. The rapid spread of the coronavirus disease 2019 pandemic throughout the world is a warning that other epidemics are still possible. Most, if not all of these diseases, transmitted by viruses or bacteria, present with cutaneous symptoms and signs that are highly important for a speedy diagnosis, a fundamental concept for arresting the diseases and saving lives. Dermatologists play a significant role in delineating cutaneous and mucosal lesions that are often lumped together as dermatitis. We provide a review of many of these cutaneous and mucosal lesions that sometimes are forgotten or even ignored.
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Affiliation(s)
- Francesco Drago
- Dermatology Unit, Ospedale Policlinico San Martino, Largo R. Benzi, Genoa, Italy; DI.S. Sal., Section of Dermatology, University of Genoa, Via Pastore 1, Genoa, Italy
| | - Giulia Ciccarese
- Dermatology Unit, Ospedale Policlinico San Martino, Largo R. Benzi, Genoa, Italy.
| | - Giulia Merlo
- Dermatology Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Via Venezia 16, Alessandria, Italy
| | - Ilaria Trave
- DI.S. Sal., Section of Dermatology, University of Genoa, Via Pastore 1, Genoa, Italy
| | - Sanja Javor
- Dermatology Unit, Galliera Hospital, Via Mura delle Cappuccine 14, Genoa, Italy
| | - Alfredo Rebora
- DI.S. Sal., Section of Dermatology, University of Genoa, Via Pastore 1, Genoa, Italy
| | - Aurora Parodi
- Dermatology Unit, Ospedale Policlinico San Martino, Largo R. Benzi, Genoa, Italy; DI.S. Sal., Section of Dermatology, University of Genoa, Via Pastore 1, Genoa, Italy
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7
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Mazori DR, Kaplan LE, Eytan DF, Heilman ER. Sporotrichoid secondary syphilis. Int J Dermatol 2020; 60:e241-e242. [PMID: 33314047 DOI: 10.1111/ijd.15337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Daniel R Mazori
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Laura E Kaplan
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Danielle F Eytan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Edward R Heilman
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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8
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Whitish Dots Provide the Key to Diagnosing Condyloma Lata: A Report of 5 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2020.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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9
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Young TK, Gutierrez D, Zampella JG. An Overview of Penile and Scrotal Dermatoses. Urology 2020; 142:14-21. [DOI: 10.1016/j.urology.2020.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/22/2020] [Accepted: 04/05/2020] [Indexed: 11/16/2022]
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10
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Magdaleno-Tapial J, Hernández-Bel P, Valenzuela-Oñate C, Miquel VAD. Whitish Dots Provide the Key to Diagnosing Condyloma Lata: A Report of 5 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:892-895. [PMID: 32574714 DOI: 10.1016/j.ad.2019.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 02/15/2019] [Accepted: 02/24/2019] [Indexed: 10/24/2022] Open
Affiliation(s)
- J Magdaleno-Tapial
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - P Hernández-Bel
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España.
| | - C Valenzuela-Oñate
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - V Alegre-de Miquel
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España
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11
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Rubins S, Esteves Morete A, Rubins A, Janniger CK, Schwartz RA. Interdigital syphilis: a rare form of secondary syphilis. Int J STD AIDS 2019; 30:1440-1442. [PMID: 31744393 DOI: 10.1177/0956462419853763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 39-year-old man with bilateral painful erosions in his toe web spaces and on the penile shaft was misdiagnosed as having Gram-negative toe web infection, and treated with broad-spectrum oral antibiotics. Further evaluation revealed positive serological tests for syphilis. Pedal interdigital syphilis is a rare manifestation of secondary syphilis.
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Affiliation(s)
- S Rubins
- Latvian Dermatology Institute, Riga, Latvia.,Department of Dermatovenereology, Medical Faculty, University of Latvia, Riga, Latvia
| | | | - A Rubins
- Department of Dermatovenereology, Medical Faculty, University of Latvia, Riga, Latvia
| | - C K Janniger
- Dermatology, Pediatrics and Pathology, Rutgers New Jersey Medical School, Newark, USA
| | - R A Schwartz
- Dermatology, Pediatrics and Pathology, Rutgers New Jersey Medical School, Newark, USA
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12
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Vaduva C, Gómez JIT, Zaid DM, Rivera-Rodríguez T. [Acute infectious disease of otolaryngology focus]. Medicine (Baltimore) 2019; 12:5339-5351. [PMID: 32287913 PMCID: PMC7143590 DOI: 10.1016/j.med.2019.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Infections are the most common cause of antibiotic prescription and one of the most frequent reasons for consultation in Primary Care. Among them, stand out acute media otitis and diffuse external otitis, acute pharyngitis and acute rhinosinusitis. Commonly they are viral and self-limited, so their complications are rare. Currently, the indiscriminate use of antibiotics have leaded to bacterial resistances; therefore antibiotic prescription should be more careful. Nowadays, several diagnostic strategies are available. In current updated etiological and pathophysiological factors of each infection, diagnostic and therapeutic strategy to be applied in Primary Care as well as the complications of each pathology and the referral indications to be assessed by specialists in the ENT area, will be reviewed.
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Affiliation(s)
- C Vaduva
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - J I Tato Gómez
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - D Mora Zaid
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - T Rivera-Rodríguez
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
- Universidad de Alcalá, Alcalá de Henares, Madrid, España
- Centro de Investigación Biomédica en Red (Ciber), Instituto de Salud Carlos III, Madrid, España
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13
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Abstract
We herein report a patient with syphilitic cervicitis and cervical cancer presenting as oropharyngeal syphilis. A 31-year-old Japanese woman with a history of unprotected vaginal and oral sex visited our hospital with right submandibular adenomas and erythema in the extremities. The fornix uteri was red, with a nodule noted. The rapid plasma reagin ratio was 1:3. She was diagnosed with syphilitic cervicitis and treated with amoxicillin for four weeks. Initial cervical cytology showed cells with mild nuclear enlargement, which was thought to be metaplasia associated with syphilis. Repeated cytology a month later showed a high-grade squamous intraepithelial lesion. A punch biopsy of the lesion led to the pathological diagnosis of cervical carcinoma in situ. We performed cervical conization, and no recurrence occurred. Human papillomavirus (HPV) immunostaining was positive in the lesion. Mucosal lesions are an infrequently reported symptom of syphilis. When oropharyngeal lesions are found, the sexual history should be ascertained, and the patient should be screened for sexually transmitted diseases. HPV is especially significant because of its association with cervical cancer. Coinfection of HPV with cervical cancer must be ruled out during follow-up for women when oropharyngeal syphilis involves genital lesions.
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Affiliation(s)
- Naoto Ishimaru
- Department of General Internal Medicine, Akashi Medical Center, Japan
| | - Yohei Kanzawa
- Department of General Internal Medicine, Akashi Medical Center, Japan
| | - Hiroyuki Seto
- Department of General Internal Medicine, Akashi Medical Center, Japan
| | - Saori Kinami
- Department of General Internal Medicine, Akashi Medical Center, Japan
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Curran J, Higgins SP. Syphilitic jaundice: a rare manifestation of the secondary stage presenting a missed opportunity to prevent ocular syphilis. BMJ Case Rep 2018; 2018:bcr-2017-223023. [PMID: 29301812 DOI: 10.1136/bcr-2017-223023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The classical presentation of secondary syphilis comprises skin rashes, mucosal ulceration and lymphadenopathy. However, this disseminated stage can also present with symptoms and signs of ocular, neurological, pulmonary, renal, musculoskeletal and digestive tract disease. We report the case of a gay man who presented with icteric hepatitis. Although he underwent an exhaustive series of investigations (some of which were invasive), syphilis was not initially considered in the differential diagnosis. His jaundice resolved spontaneously, but he subsequently developed an acute optic neuritis. Early syphilis is relatively common in men who have sex with men (MSM). Prompt diagnosis and treatment in this case would have prevented ocular involvement. Syphilis testing should be considered in all MSM presenting with unexplained symptoms and signs.
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Affiliation(s)
- Joanne Curran
- GU Medicine, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
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15
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Abstract
This article describes the various non-neoplastic lymphadenopathies that occur in patients infected with the human immunodeficiency virus (HIV), before or during the stage of acquired immunodeficiency syndrome (AIDS). The stages that develop during the HIV infection include: primary infection (acute infection, spread of the virus, development of host immune response, and acute retroviral syndrome), chronic infection or clinical latency, and finally, the AIDS stage. Non-neoplastic lymphadenopathies can occur at any of these phases of the infection and are due to multiple causes that can be divided into infectious causes (bacterial, fungal, parasitic, viral), and reactive causes (persistent generalized lymphadenopathy and a variety of situations that they also occur in immunocompetent people such as Castleman's disease and Kikuchi-Fujimoto's disease, among others). The general, histological and immunophenotypic characteristics of these pathologies are described.
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Affiliation(s)
- Carlos Barrionuevo-Cornejo
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru.
| | - Daniela Dueñas-Hancco
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
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16
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Gianfaldoni S, Tchernev G, Wollina U, Roccia MG, Fioranelli M, Gianfaldoni R, Lotti T. Syphilis Such As the Other Sexually Transmitted Diseases Are a Cultural Background of Dermatologist. Open Access Maced J Med Sci 2017; 5:551-553. [PMID: 28785361 PMCID: PMC5535686 DOI: 10.3889/oamjms.2017.125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/21/2017] [Accepted: 05/27/2017] [Indexed: 11/05/2022] Open
Abstract
Syphilis such as the other Sexually transmitted diseases are a cultural background of physician. The authors have presented this case of nodular secondary syphilis for three main reasons. The first one is that, in the last years, syphilis has re-emerged as the problem of public health. The second one is to underline how secondary syphilis, also known as the great imitator, may present itself with numerous manifestations, mimicking different dermatological diseases. Finally, because we want to remember how syphilis and the other sexual transmitted diseases must to be in the cultural background of a dermatologist, and have to be considered in the dermatological differential diagnosis.
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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 1407, Bulgaria
| | - Uwe Wollina
- Krankenhaus Dresden-Friedrichstadt, Department of Dermatology and Venereology, Dresden, Sachsen, Germany
| | - Maria Grazia Roccia
- University B.I.S. Group of Institutions, Punjab Technical University, Punjab, India
| | - Massimo Fioranelli
- G. Marconi University, Department of Nuclear Physics, Subnuclear and Radiation, Rome, Italy
| | - Roberto Gianfaldoni
- University G. Marconi of Rome, Dermatology and Venereology, Rome 00192, Italy
| | - Torello Lotti
- 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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17
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Nussipov Y, Markabayeva A, Gianfaldoni S, Tchernev G, Wollina U, Lotti J, Roccia MG, Fioranelli M, Lotti T. Clinical and Epidemiological Features of Dermatophyte Infections in Almaty, Kazakhstan. Open Access Maced J Med Sci 2017; 5:409-413. [PMID: 28785320 PMCID: PMC5535645 DOI: 10.3889/oamjms.2017.124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 11/29/2022] Open
Abstract
The cutaneous dermatomycoses are among topical issues in all countries worldwide. They are registered in 20% of the world population. Dermatophyte infections incidence frequency varies depending on a season, region, effective anti-epidemic measures management, and effective treatment methods. In Kazakhstan in 2001, dermatophyte infections ranked second in the structure of dermatologic pathology in outpatients. According to the literature data, not so many research studies on dermatophyte infections have been carried out in our country within recent years. The importance of these issues suggests a need to conduct epidemiological, clinical, microbiological studies of dermatophytosis at the present stage. A cross-sectional study was conducted, in which 195 cases of dermatophytosis were collected and investigated in the regional hospital in Almaty for the period from the beginning of January 2014 to the end of December 2014. Dermatophytoses prevalence is observed in patients within the 1 - 39 age range.
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Affiliation(s)
- Yerlan Nussipov
- State Medical Diagnostic Center, Dermatology, Almaty, Kazakhstan
| | - Assel Markabayeva
- Kazakh Medical University Continuing Education, Dermatology, Manas Street 34, Almaty 050057, Kazakhstan
| | - 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 1407, Bulgaria
| | - Uwe Wollina
- Krankenhaus Dresden-Friedrichstadt, Department of Dermatology and Venereology, Dresden, Sachsen, Germany
| | - Jacopo Lotti
- University G. Marconi of Rome, Dept. of Nuclear, Subnuclear and Radiation Physics, Rome, Italy
| | - Maria Grazia Roccia
- University B.I.S. Group of Institutions, Punjab Technical University, Punjab, India
| | - Massimo Fioranelli
- G. Marconi University, Department of Nuclear Physics, Subnuclear and Radiation; Istituto Terapie Sistemiche Integrate, Rome 00198, Italy
| | - Torello Lotti
- Universitario di Ruolo, Dipartimento di Scienze Dermatologiche, Università degli Studi di Firenze, Facoltà di Medicina e Chirurgia, Chair of Dermatology, University of Rome G. Marconi, Rome 00186, Italy
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18
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SnapshotDx Quiz: January 2016. J Invest Dermatol 2016; 136:e9-10. [PMID: 27152378 DOI: 10.1016/j.jid.2015.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Tayal S, Shaban F, Dasgupta K, Tabaqchali MA. A case of syphilitic anal condylomata lata mimicking malignancy. Int J Surg Case Rep 2015; 17:69-71. [PMID: 26555060 PMCID: PMC4701813 DOI: 10.1016/j.ijscr.2015.10.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 10/28/2015] [Accepted: 10/28/2015] [Indexed: 11/30/2022] Open
Abstract
Condylomata lata are a cutaneous manifestation of secondary syphilis and can be misdiagnosed as condylomata acuminata (warts caused by human papillomavirus), anal cancer, chancroid, haemorrhoids, tuberculosis and lymphogranuloma venereum. Condylomata lata are flesh coloured or hypo pigmented, macerated papules or plaques. We present a case of a 49-years-old gentleman who initially presented to primary care with perianal pain and peri-anal skin changes who was referred to the colorectal clinic under the two-weeks rule with suspected anal cancer. The diagnosis was confirmed by biopsy and positive standard tests for syphilis. Once condylomata lata is suspected or diagnosed, refer promptly to sexual health clinic for further investigations, treatment, contact tracing and follow up. Early treatments with intramuscular benzathine benzylpenicillin prevent serious neurological and cardiac complication.
Introduction Condylata lata in secondary syphilis is well known presentation and needs to be considered in differential diagnosis of perianal lesions. In England between 2013 and 2014 the overall incidence of infectious syphilis increased by 33% and is mainly seen in men who have sex with men. Presentation of case We report the management of a 49-years-old Caucasian homosexual man with perianal lesions that were suspicious of malignancy. After biopsies, colonoscopy, staging with computed tomography, magnetic resonance imaging and syphilis serology anal cancer was excluded and a diagnosis of syphilis was confirmed. He was referred to the sexual health clinic for the appropriate investigations and treatment. Discussion This case highlights the consideration of treatable infectious syphilis pathology. The main differential diagnosis of perianal growths to consider is condylomata acuminata (warts caused by human papillomavirus), anal cancer, syphilis, chancroid, haemorrhoids, tuberculosis and lymphogranuloma venereum. To differentiate a biopsy is needed for histopathological examination. A dense plasma cell infiltrate and numerous spirochetes visualised by immunostaining confirms condylomata lata. Conclusion In UK, it is important for colorectal surgeons to be aware of syphilitic condylomata lata and consider this when dealing with perianal lesions. It is advisable to refer patients suspected of or diagnosed with syphilis to sexual health clinics to help improve outcome. In sexual health clinics additional investigations and treatment are available in addition to partner notification and follow-up can be offered.
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Affiliation(s)
- Sarup Tayal
- Virgin Care, Sexual Health Teesside, Lawson Street Health Centre, Lawson Street, Stockton TS18 1HU UK.
| | - Fadlo Shaban
- Department of Colorectal surgery, University Hospital of North Tees, Hardwick, Stockton on Tees, TS19 8PE,UK.
| | - Kaushik Dasgupta
- Department of Histopathology, University Hospital of North Tees, Hardwick, Stockton on Tees TS19 8PE, UK.
| | - Mohamed A Tabaqchali
- Department of Colorectal surgery, University Hospital of North Tees, Hardwick, Stockton on Tees, TS19 8PE, UK.
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[Secondary syphilis]. Presse Med 2015; 44:1204-5. [PMID: 26476751 DOI: 10.1016/j.lpm.2015.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/27/2015] [Accepted: 09/15/2015] [Indexed: 11/24/2022] Open
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Siqueira CS, Saturno JL, de Sousa SCOM, da Silveira FRX. Diagnostic approaches in unsuspected oral lesions of syphilis. Int J Oral Maxillofac Surg 2014; 43:1436-40. [PMID: 25305698 DOI: 10.1016/j.ijom.2014.09.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 07/07/2014] [Accepted: 09/17/2014] [Indexed: 11/17/2022]
Abstract
Awareness of the increased prevalence of syphilis is essential for early diagnosis and treatment, and to prevent the spread of the disease. Although serological studies are the primary tool used to confirm the diagnosis of secondary syphilis, biopsy of unsuspected oral lesions is not uncommon in the routine oral pathology laboratory. In these cases, histopathological characteristics are likely to indicate the possibility of syphilis, and an immunohistochemical reaction can confirm it. The aim of the present study was to highlight the histological features and test the efficacy of immunohistochemistry in the detection of Treponema pallidum in oral lesions biopsied with the assumption of a non-syphilitic disease. Thirty-nine tissue samples from patients for whom the possibility of syphilis was suggested on the basis of histopathological findings, were retrieved from the surgical oral pathology service files and submitted to immunohistochemical staining for T. pallidum. The study was approved by the institutional ethics committee. Eighteen of the tissue samples were positive for T. pallidum. Following this, the contributing clinicians were contacted to check whether they had asked for serological examinations when the diagnostic report was received; for all 18 positive cases, the clinicians confirmed that the patients had tested positive at that time. This study shows the importance of clinical-pathological correlation and the value of immunohistochemistry in the diagnosis of unsuspected syphilis.
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Affiliation(s)
- C S Siqueira
- Department of Oral Pathology, School of Dentistry, Universidade Federal de Uberlândia, Minas Gerais, Brazil; Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil.
| | - J L Saturno
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - S C O M de Sousa
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - F R X da Silveira
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
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Cozzi A, Doria A, Gisondi P, Girolomoni G. Skin rash and arthritis a simplified appraisal of less common associations. J Eur Acad Dermatol Venereol 2013; 28:679-88. [PMID: 23980929 DOI: 10.1111/jdv.12252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 07/23/2013] [Indexed: 11/30/2022]
Abstract
Skin and joint manifestations are part of the clinical spectrum of many disorders. Well-known associations include psoriatic arthritis and arthritis associated with autoimmune connective tissue diseases. This review focuses on less common associations where skin lesions can provide easily accessible and valuable diagnostic clues, and directly lead to the specific diagnosis or limit the list of possibilities. This may also affect health care resources as diagnostic tests are often low-specific, highly expensive and poorly available. This group of diseases can be divided into two subsets, based on the presence/absence of fever, and then further classified according to elementary skin lesions (macular, urticarial, maculo-papular, vesico-bullous, pustular, petechial and nodular). In most instances joint involvement occurs as peripheral migrating polyarthritis. Erythematosus macular or urticarial rashes occur in most febrile disorders such as monogenic autoinflammatory syndromes, Schnitzler's syndrome, Still's disease and rheumatic fever and afebrile diseases as urticarial vasculitis. Pustular rash may be observed in chronic recurrent multifocal osteomyelitis (CRMO) and pyogenic arthritis with pyoderma gangrenosum and acne (PAPA) syndrome (both febrile) as well as in Behcet's disease and Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome (both non-febrile). Papular lesions are typical of secondary syphilis, sarcoidosis, interstitial granulomatous dermatitis, papular petechial of cutaneous small-vessel vasculitis and nodular lesions of polyarteritis nodosa and multicentric reticulohistiocytosis all of which are afebrile. Differential diagnosis includes infections and drug reactions which may mimic several of these conditions. To biopsy the right skin lesion at the right time it is essential to obtain relevant histological information.
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Affiliation(s)
- A Cozzi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
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Saxon CJ, Helbert MR, Komolafe AJ, Higgins SP. Rash and hepatitis within days of starting a new antiretroviral regimen: nevirapine hypersensitivity, secondary syphilis or both? Int J STD AIDS 2013; 25:228-30. [PMID: 23970648 DOI: 10.1177/0956462413497703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report a case in which an HIV-positive man developed general malaise, skin rash and biochemical hepatitis within days of starting a nevirapine-based antiretroviral treatment regimen. At the same time, his syphilis serology proved positive. We discuss the diagnostic dilemma: was this a nevirapine hypersensitivity reaction, secondary syphilis or both?
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Affiliation(s)
- Cara J Saxon
- Department of Genitourinary Medicine, North Manchester General Hospital, Pennine Acute Hospital NHS Trust, Manchester, UK
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Abstract
Syphilis is a sexually transmitted infection with various stages of evolution and a myriad of presentations. To avoid a delay in diagnosis, it is important to recognize secondary syphilis presenting with vesicular lesions. A patient presented with maculopapular rash of recent onset with several vesicles and related the eruption to paracetamol taken one day before. The differential diagnoses considered were drug eruption, pityriasis lichenoides et varioliformis acuta, pityriasis rosea and secondary syphilis. HIV, VDRL (1:256) and TPHA tests were positive and histopathology revealed lymphohistiocytic infiltrate and plasma cells. Thus, a diagnosis of secondary syphilis coexisting with HIV was confirmed. The patient was administered benzathine penicillin and anti-retroviral therapy was started. He responded very well to treatment. We report this case because of the rarity of vesicular eruption in secondary syphilis.
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Affiliation(s)
- Shikha Arora
- Department of Dermatology & Venereology, ESIC-PGIMSR, Basaidarapur, New Delhi, India
| | - Tapan K Dhali
- Department of Dermatology & Venereology, ESIC-PGIMSR, Basaidarapur, New Delhi, India
| | - Mohammad A Haroon
- Department of Dermatology & Venereology, ESIC-PGIMSR, Basaidarapur, New Delhi, India
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Zhou J, Hu C, Zheng F, Cheng H, Xuan J, Li H. Nephrogenic diabetes insipidus secondary to syphilis infection. J Clin Endocrinol Metab 2013; 98:2663-6. [PMID: 23609837 DOI: 10.1210/jc.2013-1074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Nephrogenic diabetes insipidus (NDI) is caused by partial or complete renal resistance to the effects of antidiuretic hormone. Acquired NDI can be caused by electrolyte imbalances (eg, hypercalcemia), renal/extrarenal diseases (eg, chronic pyelonephritis), and drugs (eg, lithium toxicity). Syphilis has never been reported to cause NDI. OBJECTIVE The aim of this study was to report the case of a 56-year-old man with NDI secondary to syphilis. CASE The 56-year-old patient presented with polyuria and polydipsia lasting more than 40 days. His urine specific gravity was 1.002. He had no history of chronic kidney disease or contact with toxicants. He had normal blood glucose levels. A water-deprivation test and vasopressin administration indicated NDI. His rapid plasma reagin titer was 1:128. The serum Treponema pallidum-particle agglutination test was positive. He reported engaging in unprotected, extramarital sex 6 months before polydipsia onset and thereafter developing a skin lesion on the external genitalia and arthralgia, both of which resolved spontaneously. Examination of renal biopsy specimens showed abundant plasmacytic and lymphocytic infiltration of the interstitium and low and flat tubular epithelial cells, indicating renal tubular injury. Silver staining revealed T. pallidum-like organisms. Immunohistochemical analysis with T. pallidum-specific antibody confirmed the presence of treponemes. INTERVENTION The patient received 2.4 million U of benzathine penicillin im once a week for 3 weeks. RESULTS His urine output gradually reduced; he recovered 1 month later. His urine specific gravity was 1.026, and his syphilis rapid plasma reagin titer was 1:8. CONCLUSION Syphilis can cause NDI. The manifestations of syphilis and causes of acquired NDI are diverse.
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Affiliation(s)
- Jiaqiang Zhou
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China
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Glatz M, Achermann Y, Kerl K, Bosshard PP, Cozzio A. Nodular secondary syphilis in a woman. BMJ Case Rep 2013; 2013:bcr-2013-009130. [PMID: 23661656 DOI: 10.1136/bcr-2013-009130] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
We report the case of a 21-year-old woman with symmetrically distributed, ulcerated nodules and plaques on the face, neck and arms. Initial differential diagnoses included pyoderma or sarcoidosis based on the clinical presentation and histopathology with non-caseating granulomas. After inefficient treatment with topical and systemic fusidic acid and steroids, we diagnosed nodular secondary syphilis owing to positive serology and immunohistochemical staining of Treponema pallidum in lesional skin. After treatment with benzathine penicillin, skin lesions improved and antibody titres declined significantly within 3 months. Nodular skin lesions in secondary syphilis are rare with 15 reported cases within the last 20 years. Furthermore, the granulomatous histology is often misleading. Our patient's case suggests that the physicians should be aware of syphilis as a possible differential diagnosis also in patients outside a high-risk population for sexually transmitted diseases and with an unusual clinical presentation.
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Affiliation(s)
- M Glatz
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
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Bettenworth D, Floer M, Krummenerl T, Wehrmann W, Schärer L, Heidemann J. Advanced-stage syphilis unmasking after immunomodulator therapy in a patient with ulcerative colitis. Am J Gastroenterol 2012; 107:144-5. [PMID: 22218040 DOI: 10.1038/ajg.2011.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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