Syphilis, the Great Imitator-Clinical and Dermoscopic Features of a Rare Presentation of Secondary Syphilis

HI Acquired palmoplantar keratoderma in an immunocompromised patient: A case report

Syphilis, known for its capacity to mimic various diseases, has seen rising incidence, particularly in adolescents, men who have sex with men (MSM), and individuals with HIV. Palmoplantar keratoderma (PPK), a rare manifestation of secondary syphilis, poses diagnostic challenges due to its resemblance to other conditions. We report the case of a 42-year-old man living with HIV presenting with acquired PPK, characterized by hyperkeratotic plaques on the palms and soles, alongside syphilitic roseola. Histopathology confirmed psoriasiform dermatitis with spirochetes. The patient received weekly intramuscular benzathine penicillin G, leading to significant clinical improvement without relapse. This case underscores the importance of recognizing atypical infectious presentations in individuals living with HIV and highlights the need for careful differential diagnosis in acquired PPK cases.

The dermatological manifestations and differential diagnosis of monkeypox: A narrative review

Monkeypox (MPX) is a zoonotic viral disease caused by the monkeypox virus (MPXV), which belongs to the Orthopoxvirus genus. The main clinical features of MPX are fever, rash, and lymphadenopathy. It is usually a self-limited disease and can resolve within a few weeks in most cases. MPXV is now becoming a global concern. The world health organization declared the outbreak of MPX in 2022 a global health emergency. In this article, we focus on the mucocutaneous manifestations and differential diagnosis of MPX.

Extensive Peritoneal and Pelvic Granulomatous Inflammation Due to Syphilis Infection Manifesting as Primary Infertility: A Case Report

Infertility affects millions of couples worldwide and can result from various factors, including sexually transmitted infections. Although syphilis is known to contribute to a small number of infertility cases through chronic pelvic inflammatory disease, which ultimately impairs fertility, detailed descriptions of such cases are limited. In this report, we present a case of primary infertility caused by extensive peritoneal granulomatous inflammation, adhesions, and tubal obstruction resulting from syphilis.

Oral Secondary Syphilis in an HIV-Positive Transgender Patient: A Case Report and Review of the Literature

BACKGROUND

Syphilis is a worldwide sexually transmitted infection caused by Treponema pallidum. In most cases, the oral manifestations of syphilis infection are associated with cutaneous involvement. However, the present case report is noteworthy since the oral lesions are the sole clinical sign in an HIV-positive transgender patient.

CASE PRESENTATIONS

We reported an uncommon case of secondary syphilis in a 37-year-old seropositive transgender male, whose diagnostic suspect was based only on oral mucosal lesions. The patient was referred to the Oral Medicine Unit for the presence of multiple undiagnosed painful oral lesions. The intraoral examination revealed the presence of white and red plaques on the right and the left buccal mucosa and several painful lesions localized on the upper and lower labial mucosa. No cutaneous lesions were observed. Considering the sexual history of the patient and clinical findings, secondary syphilis infection was suspected. The serologic analysis was conducted, and the diagnosis of syphilis was confirmed. Moreover, to exclude the presence of oral epithelial dysplasia or malignant disease, an incisional biopsy was performed.

DISCUSSION

Compared to the literature data, oral lesions as lone signs of secondary syphilis infection are uncommon, especially in HIV-positive patients. Syphilis and HIV coinfection create a concerning situation as they interact synergistically, leading to an increased risk of transmission and faster disease progression.

CONCLUSIONS

This case report emphasizes the importance of considering syphilis as a diagnostic possibility, even when oral lesions are the only clinical manifestations, especially in HIV-positive patients. Comprehensive evaluation, including a detailed sexual history and careful oral examination, is essential for accurate diagnosis and appropriate management in such cases.

Neurosyphilis With Concomitant Respiratory Failure: A Case Study and Treatment Considerations

This case report presents the case of a 58-year-old Caucasian male with hypercapnic respiratory failure (type 2 respiratory failure) and septic shock attributed to pneumonia. He also had multiorgan dysfunction and was subsequently diagnosed with neurosyphilis in the setting of underlying HIV. The patient initially presented with worsening shortness of breath and bilateral lower extremity edema. Further evaluation revealed HIV positivity with immunosuppression. The presence of neurologic symptoms on physical examination prompted investigation for an alternative etiology, ultimately leading to the diagnosis of neurosyphilis.