Psoriasiform Lesions of Secondary Syphilis on the Trunk
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Keywords
Secondary syphilis, syphilis, Annular, dermatovenereology
Abstract
Background Secondary syphilis typically presents as a polymorphic rash covering the palms and soles, or as mucocutaneous lesions. Although its presentation is known to be varied, it is most commonly a non-pruritic, generalized, violaceous rash.
Case Presentation We describe a case of secondary syphilis in a 64-year-old male who presented with focal annular, hyperkeratotic papules and plaques over the chest and lower abdomen that initially presented as pruritic lesions that progressed to have a burning, painful quality.
Discussion Localized manifestations of secondary syphilis have been associated with syphilitic reinfection or late manifestations of secondary syphilis and have been associated with the head and neck region. Annular lesions have also been associated with presentation in the anogenital region, palms and soles. Presentation of annular, hyperkeratotic papules and plaques localized to the trunk makes this case exceedingly unusual.
Conclusion We conclude that immunohistochemical staining is required to make the diagnosis of secondary syphilis, as morphology and distribution alone can be misleading.
References
2. Liu XK, Li J. Histologic Features of Secondary Syphilis. Dermatology. 2020;236(2):145-150. doi: 10.1159/000502641. Epub 2019 Sep 19. PMID: 31536976.
3. Centers for Disease Control and Prevention. (n.d.). Syphilis, secondary 2014 case definition. Centers for Disease Control and Prevention. https://ndc.services.cdc.gov/case-definitions/syphilis-secondary-2014/
4. 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 Nov;31(13):1323-1326. doi: 10.1177/0956462420948354. Epub 2020 Sep 27. PMID: 32981425.
5. Cheng Y, Qi T, Gu X. A Case of Perianal Annular Rash: Atypical Presentation of Recurrent Secondary Syphilis. Infect Drug Resist. 2024 Jun 19;17:2463-2466. doi: 10.2147/IDR.S470153. PMID: 38912217; PMCID: PMC11194011.
6. Ciccarese G, Facciorusso A, Mastrolonardo M, Herzum A, Parodi A, Drago F. Atypical Manifestations of Syphilis: A 10-Year Retrospective Study. J Clin Med. 2024 Mar 11;13(6):1603. doi: 10.3390/jcm13061603. PMID: 38541829; PMCID: PMC10971508.
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