Ibarra-Morales D, Pérez-Leal N, Jiménez-Mendoza D, Trujillo-Novoa S, Sierra-Garduño M, Torres-Camacho P, Arellano-Mendoza MI

Language: Spanish
References: 9
Page: 101-106
PDF size: 242.68 Kb.

ABSTRACT

Background: Malignant syphilis is a clinical entity little described in the literature, in the last three decades this disease has had an increase in its incidence since the advent of HIV.
Clinical cases: A 44-year-old male patient, widower, merchant. He began his condition with the appearance of erythematous papular lesions in the trunk, which spread throughout the body, with subsequent increase in volume of the lower left limb. The VDRL (venereal disease research laboratory) was positive at a ratio of 1:8, so a confirmatory test with positive FTA-Abs (fluorescent treponemal antibody absorption test) was requested, ELISA and Western Blot were performed, which were reactive.
Conclusion: There are few cases described in Latin America, it is important to announce this entity and propose diagnostic and therapeutic protocols since this is a rare form of presentation of secondary syphilis. This is an entity known as the great simulator both clinically and histologically; this case resembled a polymorphic erythema.

REFERENCES

1. Montes de Oca G, Tirado A, de la Herrán P, Mercadillo P, Bonifaz A. Sífilis maligna en un paciente con síndrome de inmunodeficiencia adquirida. Dermatol Rev Mex 2014;58:71-76.

2. Janier M, Hegyi V, Dupin N, Unemo M, Tiplica G, Potocnik M, French P, Patel R. 2014 European guideline on the management of syphilis. JEADV 2014;28:1581-93. doi: 10.1111/jdv.12734.

3. Hook E. Syphilis. Lancet. 2017;389:1550-57. doi: 10.1016/ S0140-6736(16)32411-4.

4. Clement M, Okeke L, Hicks C. Treatment of syphilis. A systematic review. JAMA 2014;312:1905-1917. doi: 10.1001/ jama.2014.13259.

5. US Preventive Services Task Force. Screening for syphilis infection in nonpregnant adults and adolescents: US Preventive Services Task Force Recommendation Statement. JAMA 2016;315:2321-2327. doi: 10.1001/jama.2016.5824.

6. Shulkin, D, Tripoli, L, Abell, E. Lues maligna in a patient with human immunodeficiency virus infection. Am J Med 1988;85:425-427. DOI: 10.1016/0002-9343(88)90600-6.

7. Cantor AG, Pappas M, Daeges M, Nelson HD. Screening for syphilis: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 2016;7;315(21):2328-37. doi: 10.1001/jama.2016.4114.

8. Kim YY, Lee JH, Yoon SY, Lee JD, Cho SH. Erythema multiforme- like targetoid lesions in secondary syphilis. Acta Derm Venereol. 2007;87(4):381-2. DOI: 10.2340/00015555-0252.

9. Kumar B, Muralidhar S. Malignant syphilis: a review. AIDS Patient Care STDS. 1998;12(12):921-5. DOI: 10.1089/ apc.1998.12.921.