Malignant Syphilis in an Acquired Immune Deficiency Syndrome Patient.
- Author:
Jung Yeon LEE
1
;
Min Soo KIM
;
See Hyun LEE
;
Hyun Soo KIM
;
Ji Young AHN
;
Mi Youn PARK
Author Information
1. Department of Dermatology, National Medical Center, Seoul, Korea. younskin@naver.com
- Publication Type:Case Report
- Keywords:
AIDS;
Malignant syphilis;
Noduloulcerative lesions
- MeSH:
Acquired Immunodeficiency Syndrome;
Adult;
Agglutination;
Blood Vessels;
Dermis;
Eosinophils;
Ethylenediamines;
HIV;
HIV Infections;
Humans;
Hyperpigmentation;
Lymphocytes;
Penicillin G Benzathine;
Plasma Cells;
Skin;
Syphilis
- From:Korean Journal of Dermatology
2011;49(1):68-71
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Malignant syphilis (also known as lues maligna) is a rare dermatologic manifestation of syphilis and this is more commonly seen in patients with human immunodeficiency virus (HIV) infection. A 40-year-old man presented with general malaise and widespread cutaneous noduloulcerative lesions covered with lamellar crusts for 15 days. He had been diagnosed with HIV infection 6 years earlier, but had not regularly taken antiretroviral drugs. The syphilis serology showed a VDRL (venereal disease research laboratory) titer of 1 : 256 and a positive TPPA (treponema pallidum particle agglutination test) at presentation. Histologic exam showed the dense perivascular inflammatory infiltrates composed of lymphocytes, histiocysts and neurophils with some plasma cells in the underlying upper and reticular dermis. Obliterated blood vessels with eosinophilic materials were observed as an unusual histologic feature of syphilis. Based on the clinical, histological and serological findings, a diagnosis of malignant syphilis accompanied by acquired immune deficiency syndrome (AIDS) was made. The patient was treated with intramuscular benzathine penicillin G at 2.4 million units per week for 3 weeks, and the skin lesions completely healed with post-inflammatory hyperpigmentation. It is necessary to take into account this entity among the possible diagnoses in HIV-infected patients with cutaneous noduloulcerative lesions.
