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Montero-Menárguez J, Puerta-Peña M, Agud-de Dios M, Guzmán-Pérez LM, Gutiérrez-Collar C, Fulgencio-Barbarin J. Annular genital lesions, not an unusual presentation of secondary syphilis. J Dtsch Dermatol Ges 2023; 21:907-909. [PMID: 37212344 DOI: 10.1111/ddg.15086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/10/2023] [Indexed: 05/23/2023]
Affiliation(s)
| | - Mario Puerta-Peña
- Dermatology Department of the Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Manuel Agud-de Dios
- Dermatology Department of the Hospital Universitario 12 de Octubre, Madrid, Spain
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Montero-Menárguez J, Puerta-Peña M, Agud-de Dios M, Guzmán-Pérez LM, Gutiérrez-Collar C, Fulgencio-Barbarin J. Anuläre Genitalläsionen sind bei sekundärer Syphilis nicht unüblich. J Dtsch Dermatol Ges 2023; 21:907-909. [PMID: 37574678 DOI: 10.1111/ddg.15086_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/10/2023] [Indexed: 08/15/2023]
Affiliation(s)
| | - Mario Puerta-Peña
- Dermatology Department of the Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Manuel Agud-de Dios
- Dermatology Department of the Hospital Universitario 12 de Octubre, Madrid, Spain
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Barei F, Murgia G, Ramoni S, Cusini M, Marzano AV. Secondary syphilis with extra-genital condyloma lata: A case report and review of the literature. Int J STD AIDS 2022; 33:1022-1028. [DOI: 10.1177/09564624221124710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Syphilis is known as the “great imitator” because of its polymorphic clinical manifestations. Condyloma lata are an uncommon mucocutaneous manifestation of secondary syphilis, generally localized in intertriginous areas, such as the genitals and anus. Extragenital localization of condyloma lata is considered unusual. Methods A case study of extra-genital condylomata is presented. To contextualise the case, a literature review of extra-genital condylomata lata was subsequently undertaken. The authors searched MEDLINE/PubMed, Scopus and Excerpta Medica/EMBASE English-language sources using the following keywords: “condyloma lata”, “condylomata lata”, and “condyloma latum”. Results Thirty-five papers (from 1940 to 2021) describing an extra-anogenital localization of condyloma lata were found and are summarized in Table 1. Patients were mainly males (82.1%), with a mean age of 31.9 years. Most of them showed other manifestations of secondary syphilis (53.9%). In a minority of cases (39.0%), concomitant anogenital condyloma lata were present, thus making the diagnosis easier. The toe web localization was the most documented (26.2%) followed by the oral cavity (23.8%). Conclusion In the presence of extra-genital condyloma lata, the differential diagnosis is not always clear, especially when no other muco-cutaneous lesions are observed. In the case of eroded or wet lesions involving any cutaneous fold, associated or not with other cutaneous manifestations, a sexual history should be obtained, and syphilis must be considered.
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Affiliation(s)
- Francesca Barei
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giulia Murgia
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefano Ramoni
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Cusini
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo V Marzano
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Parodi M, Ciccarese G, Drago F, Cozzani E, Buligan C, Turina M, Parodi A. Annular and arciform lesions of the palms as unique manifestations of secondary syphilis. Int J STD AIDS 2020; 31:1323-1326. [PMID: 32981425 DOI: 10.1177/0956462420948354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe a patient presenting with annular-arciform symmetric lesions of the palms as the unique manifestation of secondary syphilis. The polymorphism of skin lesions in secondary syphilis depends entirely on the degree of inflammatory infiltrate, the level of vascular involvement and the resulting ischemia of the skin. Besides the transient and diffuse maculo-papules (roseola syphilitica), secondary syphilis skin lesions may have different morphology and shape. It has already been reported that in cases of reinfections by Treponema pallidum the skin lesions may be arciform, as in our patient, and asymmetric. Indeed, previous syphilis may attenuate the clinical and laboratory manifestations of a new infection with T.pallidum, that occurs with less severe skin manifestations or presents as latent syphilis. However, to our knowledge, annular-arciform lesions of the palms as unique manifestations of secondary syphilis have never been described. Clinicians should be well trained to recognize the atypical presentations of syphilis, especially in patients who have already received a syphilis diagnosis, since its incidence is steadily increasing in Europe, especially in men having sex with men.
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Affiliation(s)
- Maria Parodi
- Dermatology Unit, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Giulia Ciccarese
- Dermatology Unit, Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Drago
- Dermatology Unit, Ospedale Policlinico San Martino, Genoa, Italy
- DI.S.Sal., Section of Dermatology, University of Genoa, Genoa, Italy
| | - Emanuele Cozzani
- Dermatology Unit, Ospedale Policlinico San Martino, Genoa, Italy
- DI.S.Sal., Section of Dermatology, University of Genoa, Genoa, Italy
| | - Cinzia Buligan
- Department of Medicine, University of Udine, Udine, Italy
| | - Marco Turina
- Institute of Pathology, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - Aurora Parodi
- Dermatology Unit, Ospedale Policlinico San Martino, Genoa, Italy
- DI.S.Sal., Section of Dermatology, University of Genoa, Genoa, Italy
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Li FG, Huang WB, Chen HS, Wang T, Fan YM. Clinicopathological, dermoscopic, and ultrastructural observation of annular secondary syphilis on the penis. Int J STD AIDS 2020; 31:699-701. [PMID: 32362198 DOI: 10.1177/0956462419900092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Annular syphilis may range from mildly raised lesions with scaly borders to verrucous plaques. Localized annular syphilis on the genitalia has been rarely reported in HIV-negative cases. This paper reports a case of annular secondary syphilis on the penis. Dermoscopy showed peripheral dotted and short linear vessels and white scaling with a relatively clear central area in an erythematous annular plaque. Histopathology revealed mild hyperkeratosis, parakeratosis, psoriasiform acanthosis, and focal basal vacuolar degeneration with lichenoid, perivascular, and periadnexal infiltrate of lymphohistiocytes and plasma cells in the superficial dermis. Silver stain showed several spirochetes in the lower epidermis and superficial dermis. Electron microscopy revealed a few intercellular and intracytoplasmic spirochetes in the basal epidermis and free spirochetes in the papillary dermis. Rapid plasma reagin and Treponema pallidum particle agglutination assays were positive. The lesions disappeared after intramuscular benzathine penicillin, with no relapse at six-month follow-up.
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Affiliation(s)
- Fang-Gu Li
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Wen-Bin Huang
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Hao-Song Chen
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Tian Wang
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yi-Ming Fan
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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