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Cantisani C, Rega F, Ambrosio L, Grieco T, Kiss N, Meznerics FA, Bánvölgyi A, Vespasiani G, Arienzo F, Rossi G, Soda G, Pellacani G. Syphilis, the Great Imitator-Clinical and Dermoscopic Features of a Rare Presentation of Secondary Syphilis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1339. [PMID: 36674095 PMCID: PMC9859468 DOI: 10.3390/ijerph20021339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Syphilis is characterized by a wide range of variable clinical symptoms; therefore, it is often referred to as "The Great Imitator". Here, we report the case of a 69-year-old hepatitis-C-positive MSM patient, who was admitted to our clinic due to a solitary firm painless erythematous maculopapular lesion with a central crater-like crust on the upper right thigh that occurred two months prior. The dermoscopy showed an erythematous, copper-colored, oval lesion with diffuse monomorphic dotted and glomerular vessels, central crust, and circular scaling (Biett's sign). The histological findings ruled out neoplasia and described a plasma cell infiltrate and endothelial swelling. Finally, the combination of the dermoscopic image, histological findings and the additionally acquired knowledge about the sexual history of the patient at the second visit led to the diagnosis, which was then confirmed with serological tests. Dermoscopy may become a supportive tool to facilitate the recognition of secondary syphilis; however, the reporting of these atypical cases is crucial to highlight the many faces of the disease so that clinicians consider syphilis as part of the differential diagnosis of non-specific lesions.
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Affiliation(s)
- Carmen Cantisani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Federica Rega
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Luca Ambrosio
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Teresa Grieco
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Norbert Kiss
- Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - Fanni Adél Meznerics
- Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - Giordano Vespasiani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Francesca Arienzo
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza Medical School” University of Rome, 00161 Rome, Italy
| | - Giovanni Rossi
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Giuseppe Soda
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza Medical School” University of Rome, 00161 Rome, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
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Ichane F, Duquenne S, Poubeau P, Dupin N, Bertolotti A. Secondary syphilis: An ecthyma-like syphilis case report. Ann Dermatol Venereol 2022; 149:209-210. [PMID: 35710538 DOI: 10.1016/j.annder.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/01/2021] [Accepted: 01/14/2022] [Indexed: 10/18/2022]
Affiliation(s)
- F Ichane
- Service des maladies infectieuses, dermatologie, CHU La Réunion, 97448 Saint-Pierre Cedex, Reunion.
| | - S Duquenne
- Laboratoire d'anatomopathologie, CHU La Réunion, 97448 Saint-Pierre Cedex, Reunion
| | - P Poubeau
- Service des maladies infectieuses, dermatologie, CHU La Réunion, 97448 Saint-Pierre Cedex, Reunion
| | - N Dupin
- Service de dermatologie-vénéréologie, faculté de médecine, université Sorbonne Paris Descartes, Inserm, Institut Cochin U1016, laboratoire de dermatologie-CNR des IST bactériennes expertise Syphilis, AP-HP, groupe hospitalier Paris Centre Cochin-Hôtel Dieu-Broca, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - A Bertolotti
- Service des maladies infectieuses, dermatologie, CHU La Réunion, 97448 Saint-Pierre Cedex, Reunion; Inserm CIC1410, CHU La Réunion, 97448 Saint-Pierre Cedex, Reunion
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Abstract
The authors describe an atypical case of primary syphilis of the neck. The unusual clinical presentation and localization led to an initial diagnostic mistake. This case confirms the polymorphic character of syphilis. Considering the increased incidence of sexually transmitted infections worldwide, a high index of suspicion should be maintained by physicians.
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Ramoni S, Ponziani A, Boneschi V, Pastena A, Cusini M. Annular secondary syphilis. GIORN ITAL DERMAT V 2019; 154:93-94. [DOI: 10.23736/s0392-0488.17.05627-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Li QF, Han K, Gurung I, Peng XB. Secondary syphilis presented with impetigo-like lesions: a rare case report. Int J Dermatol 2018; 57:e141-e142. [PMID: 30094832 DOI: 10.1111/ijd.14134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/02/2018] [Accepted: 06/13/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Qiao-Fei Li
- Department of Dermatology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - Kai Han
- Department of Dermatology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - Ishwor Gurung
- Department of Dermatology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - Xue-Biao Peng
- Department of Dermatology; Nanfang Hospital; Southern Medical University; Guangzhou China
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