No abstract available.
Chancre ; Lip

No abstract available.
Chancre ; Homosexuality

No abstract available.
Chancre* ; Eczema* ; Nipples*

Objective To analyze the reasons of misdiagnosis of primary syphilitic chancre and strengthen the understanding of atypical features of this disease. Methods A case series of twenty-seven challenging primary syphilis patients who were not immediately recognized as chancre was included in our study. The clinical data including the patients' age, sex, skin lesions, HIV status, syphilis serologic test results, treatment, and follow-up results were collected. Hematoxylin-eosin and immunohistochemistry staining of skin biopsy sections were reviewed. Results Four female cases with extragenital chancres presenting as erythema or erosive skin lesions on the nipple were misdiagnosed as Paget's disease or eczema. The disorder of missed or misdiagnosed male cases manifested as syphilitic balanitis or multiple chancres on the penis root and adjacent pubis rather than coronal sulcus or frenum. Patients with nonreactive nontreponemal tests at initial presentation were also easily missed or misdiagnosed. Conclusion Primary syphilis presenting as multiple lesions rather than a single chancre, at atypical locations, or with a nonreactive nontreponemal test result, tends to be missed or misdiagnosed.
Chancre/diagnosis* ; Female ; Humans ; Male ; Nipples ; Skin ; Syphilis/diagnosis*

Syphilis, a chronic systemic infection caused by Treponema pallidum, is usually sexually transmitted and characterized by episodes of active disease interrupted by a latent period. After an incubation period of averaging 2-6 weeks, a primary syphilis with a firm, non-tender chancre appears, often associated with regional lymphadenopathy. Secondary syphilis shows localized or diffuse mucocutaneous lesions and generalized non-tender lymphadenopathy. In about onethird of untreated cases, the tertiary stage appears, characterized by progressive destructive mucocutaneous, musculoskeletal or parenchymal lesions, aortitis or symptomatic central nervous system diseases. Without serological testing, the precise diagnosis is very difficult. In fact, it has often been called the great imitator because it was often confused with other disease. We report a very unusual case of luetic lymphadenitis presented as a solitary submandibular mass.
Aortitis ; Central Nervous System Diseases ; Chancre ; Lymphadenitis ; Lymphatic Diseases ; Neck ; Serologic Tests ; Syphilis ; Treponema pallidum

Primary inoculation tuberculosis results from the inoculation of mycobacteria into the skin of a host not previously infected with tuberculosis. Tuberculous chancre and the affected regional lymph nodes constitute the tuberculous primary complex of the skin. A 21-year-old female visited our clinic with an erythematous, ulcerative, indurated plaque on her right upper eyelid. The skin lesion developed 2 months after bilateral upper blepharoplasty. The results of a skin biopsy with acid-fast bacilli staining and polymerase chain reaction were compatible with tuberculosis of the skin. After 9 months of antituberculosis chemotherapy, the skin lesion was improved.
Biopsy ; Blepharoplasty ; Chancre ; Drug Therapy ; Eyelids ; Female ; Humans ; Lymph Nodes ; Polymerase Chain Reaction ; Skin ; Tuberculosis* ; Ulcer ; Young Adult

Primary syphilis affects the genital and, less frequently, the extragenital regions. Approximately two-thirds of extragenital chancres occur above the neck, and about one-half of these are seen on the lips, the perioral region, or in the oral cavity. We present a case of a 32-year-old woman with a 2-month history of discharging ulcers on both oral angles. She had a history of orogenital sexual contact. Serologic tests for syphilis was positive, particularly the VDRL (1:128), confirmed by TPHA. The biopsy specimen showed a predominant infiltration of plasma cells in the dermis. The skin lesions improved after 4 weeks treatment with doxycycline.
Adult ; Biopsy ; Chancre ; Dermis ; Doxycycline ; Female ; Humans ; Lip ; Mouth ; Neck ; Plasma Cells ; Serologic Tests ; Skin ; Syphilis ; Ulcer

A clinical survey on the syphilitic cases of the military personnel was carried out during the period of 18 months from July, l976 to December, 1977 by means of ready-made STD chart and questianaire. This survey included 180 cases of syphilitic patients who had been diagnosed and treated in the Dept. of Dermatology of ROK Army Hospital. The results can be summarized as follows: I . Total 180 cases af syphilis were classified as 147 cases (81.7%) of secondary syphilis, 22 cases (12. 2%) of primary syphilis and 11 cases (6. l%) of latent syphilis. The cases of secondary syphilis were camposed of 96 cases (65. 3%) of alopecia syphilitica, 88 cases (60.0%) of condyloma latum, 12 cases (8. 2%) of macular syphilid and 1 case (0. 7%) of mucous patch, each. 3. Among 147 cases of secondary syphilis, 42 cases (28.6%) had a positive history of typical chancre at the genital region. III. 68. 3% of patients had first sexual experience between the age of 18 and 20 and the average age was 19.1 years. 71.7% of total patients of syphilis were between the age of 21 and 23 and the average age was 22.8 years. IV. Fourteen cases(63.6%) of primary syphilis had the chancre on the coronal sulcus, 4 cases(18.2%) on the prepuce, 3 cases(13.6%) on the penile shaft and 1 case(4.5%) on the glans penis. V. To review the number of the lesion of 88 cases of condyloma latum, 45 cases(51.1%) had one to three lesions and the average number of the lesion was 3.7 Predilection sites of condyloma latum were perianal region(90.9%), penile shaft(11.4%), scrotum(6.8%) and corona and coronal sulcus(4.5%). VI. Out of 180 cases, 76 cases(42.2%) had a past history of other STD, and 26 cases(14.4%) had other coincidently combined STD which were composed of condyloma acuminatum(8.9%) urethritis(3.3%), chancroid(1.6%) and pediculosis pubis(0.6%). VII. The most common partners of the first sexual experience was lover(50.0%) and followed by barmaid(25.6%) and prostitute(8.9%). Barmaid(56.7%) was the most frequently suspected source of present infection and other sources were prostitute(18.9%) and lover(.9.4%).
Alopecia ; Chancre ; Dermatology ; Hospitals, Military ; Humans ; Lice Infestations ; Male ; Military Personnel ; Penis ; Syphilis* ; Syphilis, Cutaneous ; Syphilis, Latent

Serologic tests for syphilis, including VDRL and TPHA tests, and Physical examination were carried out on 1, 605 subjects who lived in Taegu Hope Village, a social welfare center, from April, 198R to May, 1985. We prepared this study comparing with previous reports for healthy individuals and prostitutes. The results were as follows, The reactive rate of VDRL. qualitative test was 11. 6% in total, 10. 3%, in men and l3. 5%. in women. The reactive rates of VDRL. qualitative tests were highest in 7 th decade as 28, 7% and followed by 6 th decade as 16. 7% the decacile as 16. 0% 8 th decade as 14,3% 4th decade as 8. 8% and 3rd decade as 5. 9%, 3 In ]Hg sero-positive subjects, VDRL quantitative tests were done, and 35. 5% were reacted with 1: 8 or high and 29. 0% had one or more syphilitic lesions. 4 In 54 subjects who had one or more syphilitic lesions, 19 had chancres, 17 had alopecia syphilitica, 7 had rnaculopapular syphilid, 7 had condylomata lata. 3 had papular syphilid, and 1 had maculopapular syphilid and alopecia syphilitica. The biological false positive rate was 10. 1,4 in 138 VDRL reactive subjects, using 1;he TPHA test standard.
Alopecia ; Chancre ; Daegu ; Female ; Hope* ; Humans ; Male ; Physical Examination ; Prevalence* ; Serologic Tests ; Sex Workers ; Social Welfare ; Syphilis* ; Syphilis, Cutaneous

Using the FTA-ABS complernent test, 32 skin speciruens from 27 patients with primary and secondary syphilis and a stomach specimen from a patient with suspected gastric syphilis which were confirmed by clinical history, physical examination, VDRL, FTA-ABS, and 19S(IgM)-FTA test, were tested. The following results were obtained. 1. In the darkfield examination, 7 of the 9 specimens(78%) were positive and in the FTA-ABS complernent test, 20 of the 33 specimens(61%) were positive. 2. The ratio of agreement between the darkfield examination and the FTA-ABS complement test was 89%. 3. In the chancres, macular syphilids, and condyloma lata, T. pallida were diffusely scattered in the epidermis, dermoepidermal junction, connective tiasue, and vascular walls, whereas in the papular syphilid T. pallida were mainly aggregated in the the epidermis, dermoepidermal junction, papillary dermis as well as the blood vessel walls in the papillary dermis. From these results, the FTA-ABS complement test can be considered to be a useful method for both the diagnosis and research of syphilis. It is especially helpful in cases where serological or histopathological study can not confirrn the diagnosis as when internal organs are involved.
Blood Vessels ; Chancre ; Complement System Proteins* ; Dermis ; Diagnosis ; Epidermis ; Humans ; Physical Examination ; Skin ; Stomach ; Syphilis ; Syphilis, Cutaneous ; Treponema pallidum* ; Treponema*