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Lopes-Santos G, Zanda MJ, Tjioe KC, Oliveira DT. Isolated primary syphilitic chancre in the lower lip of a teenager. Int J Dermatol 2023; 62:e641-e643. [PMID: 37571874 DOI: 10.1111/ijd.16807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Affiliation(s)
- Gabriela Lopes-Santos
- Department of Surgery, Stomatology, Pathology, and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marcelo J Zanda
- Clinical Research Center, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Kellen C Tjioe
- Georgia Cancer Center, Augusta University, Augusta, GA, USA
| | - Denise Tostes Oliveira
- Department of Surgery, Stomatology, Pathology, and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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2
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Figueroa-Ramos G, Rodríguez-Gutiérrez G, Domínguez-Cherit J. [Syphilitic chancre in the mouth: an unusual location. Case report]. Rev Med Inst Mex Seguro Soc 2022; 60:703-707. [PMID: 36283073 PMCID: PMC10395963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Syphilis is an infectious disease caused by the spirochete Treponema pallidum, transmitted mainly by direct contact with the lesion. Primary syphilis usually presents with a chancre at the site of infection, which is highly contagious and resolves without treatment. The aim of this article is to illustrate an unusual location of a syphilitic chancre, in order to consider this diagnosis within the approach to patients with oral ulcers. CLINICAL CASE a 30-year-old man who presented a dermatosis located in the left labial commissure, characterized by a painless ulcer of 1 cm in diameter of 20 days of evolution. The patient has a history of HIV/AIDS. A punch biopsy of the dermatosis was performed, with a histopathological report compatible with syphilitic chancre and a negative VDRL result. He was treated with penicillin G benzathine showing improvement. CONCLUSIONS Primary syphilis is characterized by the development of the syphilitic chancre, which is the first manifestation of syphilis in up to 60% of cases. Extragenital presentation is rare, with only 12-14% of all cases, and of these between 40-70% occur in the mouth, being the lips the most frequent location. Oral manifestations can represent a diagnostic challenge due to its wide spectrum of clinical presentations.
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Affiliation(s)
- Grecia Figueroa-Ramos
- Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Dermatología. Ciudad de México, México
| | - Georgina Rodríguez-Gutiérrez
- Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Dermatología. Ciudad de México, México
| | - Judith Domínguez-Cherit
- Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Dermatología. Ciudad de México, México
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3
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Wang Q, Zheng JN, Xu JM, Zhong YS. An irregular ulcer in the rectum. BMJ 2021; 372:n316. [PMID: 33602665 DOI: 10.1136/bmj.n316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Qiang Wang
- Department of Dermatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ji-Na Zheng
- Department of Dermatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian-Min Xu
- Department of Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yun-Shi Zhong
- Department of Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
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4
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Orgaz Rosúa MJ, Herruzo Zúñiga N. Chancro extragenital en paciente homosexual. Aten Primaria 2020; 52:131-132. [PMID: 31122760 PMCID: PMC7025964 DOI: 10.1016/j.aprim.2019.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 02/25/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- M José Orgaz Rosúa
- Medicina Familiar y Comunitaria, Centro de Salud Gran Capitán, Granada, España
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Affiliation(s)
- Victor Olsavszky
- Department of Dermatology, Venereology, and Allergy, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Cyrill Géraud
- Department of Dermatology, Venereology, and Allergy, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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6
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Tang XJ, Gan EY. Painless ulcer on the areola. Cutis 2018; 102:26-32. [PMID: 30138503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Xinjie J Tang
- Yong Loo Lin School of Medicine, National University of Singapore
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7
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Ong JJ, Towns JM, Chen MY, Fairley CK. Occult syphilitic chancres in the rectum and oropharynx. Aust Fam Physician 2017; 46:673-675. [PMID: 28892599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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8
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Abstract
In the differential diagnosis of patients with ulcers on the lips characteristics like the duration of the ulcer, number, size, depth, shape, base, margins, and distribution are considered. Such ulcers arise from many diseases particularly, viral and bacterial infections, malignancies can also be responsible. Classic syphilitic chancres are painless erosions settled on hard papule; these are evident in the genital area in more than 90% of patients. This study describes a case of a 38-year-old female patient presenting with a painful ulcer covering 3 quarters of the upper lip showing settlement on erythematous, edematous, and indurated plaque covered with hemorrhagic crusts. The aim of this study was to consider differences between the classic syphilitic chancre typically found in the genital region from extragenital chancres and to raise awareness of the possibility of primary syphilis when patients present with painful ulcers on the lip.
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Affiliation(s)
- Filiz T Demir
- Department of Dermatology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey. E-mail.
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9
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Abstract
An HIV-positive heterosexual man presented with a recurrent penile chancre, 20 months after treatment with intramuscular procaine benzyl penicillin. Was this a rare case of chancre redux (monorecidive) or re-infection?
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Affiliation(s)
- O McQuillan
- Department of Genitourinary Medicine, Manchester Royal Infirmary, UK.
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11
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Grillo E, Vano-Galvan S, Miguel-Morrondo A, Jaén P. Multiple penile lesions - a case study. Aust Fam Physician 2012; 41:701-702. [PMID: 22962647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A man, 34 years of age, presented with a 4 day history of painless ulcerative lesions on his penis.
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Affiliation(s)
- Emiliano Grillo
- Department of Dermatology, Ramon Y Cajal University Hospital, Madrid, Spain.
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12
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Affiliation(s)
- Hsien-Yi Chiu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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13
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Febbraro I, Manetti G, Balestrieri P, Zippi M. Rectal cancer or rectal chancre? Beware of primary syphilis. Dig Liver Dis 2008; 40:579-81. [PMID: 18313998 DOI: 10.1016/j.dld.2007.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Revised: 08/21/2007] [Accepted: 09/10/2007] [Indexed: 02/07/2023]
Abstract
The prevalence of sexually transmitted diseases (STD) has risen in recent years [Brown AE, Sadler KE, Tomkins SE, McGarrigle CA, LaMontagne DS, Goldberg D, et al. Recent trends in HIV and other STIs in the United Kindom: data to the end of 2002. Sex Transm Infect 2004;80:159-66]. Homosexually active men have frequent intestinal and rectal symptoms due to sexually acquired gastrointestinal infections [Surawicz CM, Goodell SE, Quinn TC, Roberts PL, Corey L, Holmes KK, et al. Spectrum of rectal biopsy abnormalities in homosexual men with intestinal symptoms. Gastroenterology 1986;91:651-9]. The number of reported cases of primary syphilis is increasing especially among this group of people [Goh BT. Syphilis in adults. Sex Transm Infect 2005;81:448-52 ]. We herein describe a case of a young man with a primary syphilitic rectal localization mimicking rectal cancer.
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Affiliation(s)
- I Febbraro
- Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy.
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14
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Badri T, Cherif F, Sioud Dhrif A, Ben Tekaya N, Ben Osman Dhahri A. [Primary and secondary syphilis in a pregnant woman]. Tunis Med 2008; 86:606-608. [PMID: 19222140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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16
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Abstract
A 33-year-old woman presented with a 4-months history of a granulating ulcer on the right index finger. Paronychia was suspected and nail extraction with subsequent histopathologic examination of the removed tissue was performed. Two months later, it became known that the patient's sexual partner had been treated for syphilis. The patient's serology was also positive. Subsequent examination of the original tissue sample by polymerase chain reaction, immunohistochemistry using Treponema pallidum-specific antibodies, and silver staining revealed large numbers of syphilis bacteria, confirming the diagnosis of extragenital chancre.
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Affiliation(s)
- W Anemüller
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
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17
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National guideline for the management of late syphilis. Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). Sex Transm Infect 1999; 75 Suppl 1:S34-7. [PMID: 10616380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
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18
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Janier M. [Syphilis (except congenital syphilis)]. Ann Dermatol Venereol 1999; 126:625-8. [PMID: 10530355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- M Janier
- Centre Clinique et Biologique des MST, Hôpital Saint-Louis, Paris
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19
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National guideline for the management of early syphilis. Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). Sex Transm Infect 1999; 75 Suppl 1:S29-33. [PMID: 10616379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
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20
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Abstract
Adamantiades-Behçet's disease was diagnosed in a 42 year old Turkish patient with recurrent oral aphthae, genital ulcerations, papules, and sterile pustules, histologically presenting as cutaneous vasculitis, and intermittent arthritis with joint effusion particularly of the knees. Six months after initial improvement under treatment with colchicine 2 mg/day, a solitary genital ulcer with enlarged inguinal lymph nodes appeared and persisted for 7 weeks despite the continuation of colchicine treatment and the introduction of clindamycin 2 mg/day intravenously. The unusual persistence of the ulcer and the failure of clindamycin therapy led to further differential diagnostic considerations and the identification of primary syphilis. The genital lesion healed 4 weeks after initiation of treatment with tetracycline 2 mg/day by mouth for 15 days.
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Affiliation(s)
- N Meljanac
- Department of Dermatology, University Medical Center Benjamin Franklin, Free University of Berlin, Germany
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21
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Latif AS. Syndromic management of sexually transmitted diseases. Part 3--The management of genital ulcers and inguinal buboes. Cent Afr J Med 1998; 44:266-71. [PMID: 10101439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- A S Latif
- Department of Medicine, University of Zimbabwe Medical School, Avondale, Harare, Zimbabwe
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Affiliation(s)
- S Arunkumar
- Institute of Venereology, Government General Hospital, Chennai Medical College, Tamilnadu, India
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Abstract
A case of primary tuberculous chancre of the vulva is reported. Although a tuberculous infection in an immunocompromised patient is not uncommon, this is the first report of a primary tuberculous infection on the external genitalia in such a patient. The source of infection in this patient could not be determined.
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Affiliation(s)
- S N Tham
- National Skin Centre, Singapore, China
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25
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Cervantes García M. [Genital pathology: sexually transmitted diseases]. Aten Primaria 1989; 6:511-7. [PMID: 2518955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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26
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George D, Alexander WJ. Possible penicillin treatment failure in primary syphilis. Ala J Med Sci 1988; 25:427-9. [PMID: 3218691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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27
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Abstract
A 39-year-old Norwegian seaman developed penile ulcerations after sexual contact overseas. The diagnosis of syphilitic chancre and of chancroid was confirmed. The ulcers healed after combined treatment with benzathine penicillin and trimethoprim-sulfamethoxazole.
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Koźmińska-Kubarska A, Banza L. [Venereal ulcer. Observation of 24 cases]. Przegl Dermatol 1983; 70:69-72. [PMID: 6658012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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29
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Abstract
A 24-year-old man who had been in contact with a woman who had infectious syphilis developed a painless sore on his penis. His general practitioner prescribed tetracycline (250 mg four times a day for seven days). After approximately one month he developed another painless sore at the same site as the previous one. The diagnosis of syphilis was confirmed by dark-field microscopy and serologic tests. Reinfection was thought to be unlikely because he denied having sexual intercourse after the first visit to his general practitioner. Thus, the new lesion was thought to be a case of monorecidive syphilitic chancre.
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30
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Fiumara NJ. Treatment of primary and secondary syphilis. Serological response. JAMA 1980; 243:2500-2. [PMID: 7382036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
One hundred thirty-eight patients with primary syphillis and 161 patients with secondary syphilis were treated with penicillin G benzathine, 2.4 million units given intramuscularly weekly for two weeks, for a total of 4.8 million units. All 138 patients with primary syphilis had a rapid resolution of their lesions, and all became seronegative within one year. Similarly, the 161 patients with secondary syphilis were cured clinically, and all achieved seronegativity within 24 months.
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Voinchet O, Guivarc'h M. [Syphilis of the rectum mimicking neoplastic disease (author's transl)]. Gastroenterol Clin Biol 1980; 4:134-6. [PMID: 7364171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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32
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Vasil'ev TV, Vinokuriv IN, Gracheva GK, Ivanov IA, Ovsiannikov LM. [Immediate results of the comprehensive treatment of infectious forms of syphilis with erythromycin, bismuth and nonspecific preparations]. Vestn Dermatol Venerol 1978:78-82. [PMID: 360681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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33
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Maldybaev AM, Derbinskaia GM, Rovenskii IZ. [Phagedenic indurated chancre]. Vestn Dermatol Venerol 1976:82-3. [PMID: 1014828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Abstract
A case of primary syphilitic chancre of the coronal sulcus with subsequent development of syphilitic balanitis of Follmann is described. The histopathological picture and preponderantly intraepidermal localization of T. pallidum in the lesions is discussed.
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Zorin PM. [Pathomorphosis of syphilis, its causes and genesis]. Vestn Dermatol Venerol 1974:29-35. [PMID: 4446721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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