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Revista Médica Sinergia

2023, Number 06

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Revista Médica Sinergia 2023; 8 (06)

Malignant syphilis as an atypical clinical manifestation of secondary syphilis

Calderón-Wong LA, Arguedas-Ortiz J, Ulloa-Castro ML

Language: Spanish
References: 19
Page:
PDF size: 311.97 Kb.


ABSTRACT

Malignant syphilis (MS) is a rare form of secondary syphilis. The pathogenesis is unknown; however, it is recognized that it is more common in immunocompromised patients or in patients with poor health, and mainly in patients with HIV coinfection. Within the clinical manifestations of secondary syphilis, mucocutaneous and systemic findings can be found. MS shares a tropism with secondary syphilis, so skin lesions can be found on the trunk, extremities, mucous membranes, palms of the hands, soles of the feet, and scalp. These lesions are characterized by disseminated pustules that tend to evolve into nodular lesions with a necrotic center and/or hyperkeratosis. The diagnosis is based on the patient's symptoms, confirmation by dark field microscopy, serology, and characteristic histology such as infiltrates of lymphocytes and plasma cells in the dermis. The treatment of choice is penicillin, like all patients with syphilis. Being a sexually transmitted disease, it is essential to evaluate the patient's sexual partners and provide them with treatment.


REFERENCES

  1. Toledo-Pastrata T. Sífilis precoz: nuevas aproximaciones diagnósticas para un escenario cambiante. Actas Dermosifiliogr [Internet]. 2020 [citado el 21 marzo, 2023];111:87-88. Disponible en: https://www.actasdermo.org/es-sifilis-precoz-nuevas-aproximaciones-diagnosticas-articulo-S0001731019301279

  2. Çakmak SK, Tamer E, Karadağ AS, Waugh M. Syphilis: A great imitator. Clinics in Dermatology. [Internet]. 2019 [citado el 21 Mar 2023];37(3):182–91. Disponible en:https://www.sciencedirect.com/science/article/abs/pii/S0738081X19300070?via%3Dihub

  3. Ehlers S, Sergent S, Ashurst J. Secondary syphilis. Clinical Practice and Cases in Emergency Medicine. [Internet]. 2020 [citado el 21 Mar 2023];4(4):675–6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33217306/

  4. Valerga M, Sánchez Cunto M, Bruni G, Picollo M, Priarone M, Maiolo E, et al. Sifilides elegantes de BROCQ en una paciente con SIDA y sífilis secundaria. Presentación de un caso y revisión de la literatura. La prensa médica argentina. [Internet]. Mayo 2020 [citado el 21 marzo 2023];106(3):145–9. Disponible en: https://www.academia.edu/43360294/Sifilides_elegantes_de_BROCQ_en_una_paciente_con_SIDA_y_s%C3%ADfilis_secundaria_Presentaci%C3%B3n_de_un_caso_y_revisi%C3%B3n_de_la_literatura. Se requiere subscripción.

  5. Khaw C, Malden C, Ratnayake M, Boyd M. Diagnosis and management of syphilis in patients with HIV co-infection. Current Treatment Options in Infectious Diseases. [Internet]. 2020 [citado el 21 marzo 2023];12(3):215-26. Disponible en: https://link.springer.com/article/10.1007/s40506-020-00225-6.

  6. Luo Y, Xie Y, Xiao Y. Laboratory diagnostic tools for syphilis: Current status and future prospects. Frontiers in Cellular and Infection Microbiology. [Internet]. 2021 [citado el 21 marzo 2023];10. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897658/

  7. Yancheva N, Petrova E, Tchervenyakova T. Atypical secondary syphilis presentation in a patient with human immunodeficiency virus infection: A case report. Journal of Medical Case Reports [Internet]. 2019 [citado el 21 marzo 2023];13(1). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900840/

  8. Fustà-Novell X, Morgado-Carrasco D, Barreiro-Capurro A, Manzardo C, Alsina-Gibert M, Fuertes-de Vega I, et al. Sífilis Maligna, una presentación de sífilis a tener en cuenta. Actas Dermo-Sifiliográficas [Internet].2018 [citado el 21 marzo 2023];110(3):232–7. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0001731018303545

  9. Sá Lopes R, Monteiro AS, Saez R, Candeias C, Mendonça C. Malignant syphilis: A rare case of early secondary syphilis in an immunocompetent patient. European Journal of Case Reports in Internal Medicine [Internet]. 2023 [citado el 21 marzo 2023]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36819650/

  10. Wibisono O, Idrus I, Djawad K. Malignant syphilis: A systematic review of the case reports published in 2014-2018. Actas Dermo-Sifiliográficas (English Edition) [Internet]. 2021 [citado el 21 marzo 2023];112(8):725–34. Disponible en: https://www.sciencedirect.com/science/article/pii/S1578219021001748

  11. Alazán Pérez L, Gutiérrez Contreras R, Fong Fernández T, Álvarez Méndez MÁ. Sífilis maligna precoz en paciente inmunocompetente. Folia Dermatológica Cubana [Internet]. 2018 [citado el 21 marzo 2023];12(1). Disponible en: https://revfdc.sld.cu/index.php/fdc/article/view/79/121

  12. Zhu L, Shi M, Peng R-R, Gu X, Guan Z, Xu H, et al. Neurosyphilis is more common in malignant syphilis: A case series and review of the literature. International Journal of STD & AIDS [Internet]. 2019 [citado el 21 marzo 2023];30(8):779–85. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31142223/. Subscription is required.

  13. Hicks CB, Clement M. Syphilis: Epidemiology, pathophysiology, and clinical manifestations in patients without HIV [Internet]. UpToDate. 2022 [citado el 21 marzo 2023]. Disponible en: https://www-uptodate-com.bibliotecaucimed.remotexs.co/contents/syphilis-epidemiology-pathophysiology-and-clinical-manifestations-in-patients-without-hiv/print?search=syphilis&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3

  14. Pereira AS, Lozada A, Monteiro AF. Malignant syphilis in a patient with acquired humanimmunodeficiency virus (HIV) infection. Anais Brasileiros de Dermatologia [Internet]. 2022 [citado el 21 marzo 2023];97(5):641–3. Disponible en: https://www.anaisdedermatologia.org.br/en-malignant-syphilis-in-patient-with-articulo-S0365059622001295

  15. Dimnik J, Benko M, Hosta V, Murnik Rauh A, Pagon A, Špik VC, et al. Malignant syphilis in a female patient: A case report and Mini-Review. Tropical Medicine and Infectious Disease [Internet]. 2022 [citado el 21 marzo 2023];7(3):47. Disponible en: https://www.mdpi.com/2414-6366/7/3/47

  16. Bolognia JL, Schaffer JV, Cerroni L, editores. Dermatolog a. 4a ed. Elsevier; 2018.

  17. Jalili A. Malignant syphilis in a HIV infected female patient. Sexually Transmitted Diseases [Internet]. 2019 [citado el 21 marzo 2023]:29–32. Disponible en: https://www.rosenfluh.ch/media/dermatologie-aesthetische-medizin/2019/03/Malignant-syphilis-in-an-HIV-infected-female-patient.pdf

  18. Hicks CB, Clement M. Syphilis: Treatment and monitoring [Internet]. UpToDate. 2022 [citado el 06 Mar 2023]. Disponible en: https://www-uptodate-com.bibliotecaucimed.remotexs.co/contents/syphilis-treatment-and-monitoring?search=syphilis%20&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

  19. Granizo-Rubio J, Caviedes-Vallejo C, Chávez-Dávila N, Pinos-León V. Sífilis maligna y erupción papular pruriginosa en un paciente VIH positivo. Actas Dermosifiliogr [Internet]. 2020 [citado el 21 marzo 2023];111(3):269-271. Disponible en: https://www.actasdermo.org/es-sifilis-maligna-erupcion-papular-pruriginosa-articulo-S0001731019303862




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