Background: Recently, the incidence of syphilis among men who have sex with men (MSM) has increased rapidly, especially among Human Immunodeficiency Virus (HIV)-infected MSM. Coinfection with these two organisms alter the symptoms and signs, progression of the disease, and the risk of progressing to the tertiary stage. Purpose: To report a case of secondary syphilis in HIV-infected MSM. Case: A 24-year-old male complaint of multiple redness macule for 1-month duration on his chest, back, groin, palm, and soles. The rash was neither painful nor pruritic. He also complains of hair loss resulting "moth eaten" alopecia. One month before, he had a painless ulcer on his genital, which resolved without treatment. His HIV infection was diagnosed two years earlier. He had been sexually active with multiple homosexual partners without using a condom since 2010. The Venereal Disease Research Laboratory test (VDRL) titer was 1/32, and Treponema pallidum haemagglutination assay (TPHA) was 1/20480. Initial treatment was a single dose of 2.4 million units of benzathine penicillin. Serologic examination was reevaluated on month 1, 3, 6, and 9 after therapy and declined in the third month. Discussion: For HIV-infected persons, the clinical manifestations of syphilis in most of the cases remain the same. However, the lesions are more aggressive, and coexistence of primary and secondary syphilis is more frequent. Serologic tests are accurate and reliable for the diagnosis and for following a patient’s response to treatment. Penicillin is effective but physical and serological follow up is needed. Conclusion: HIV-infected MSM have higher risk of syphilis. Staging is needed to determine the treatment. Serologic examination should be repeated and long enough to monitor the treatment success.
Background: Vitamin D has been shown to have an immunomodulatory effect, and previous studies have proven that vitamin D deficiency contributed to several autoimmune diseases, including psoriasis. Purpose: The purpose of this study was to determine serum vitamin D levels in psoriasis vulgaris patients and compare them with control subjects. Methods: The research samples were sixteen adults with psoriasis vulgaris and 16 control subjects. Blood samples were taken, and the serum 25 (OH) D levels were measured using the Chemiluminescent Microparticle Immunoassay method. Result: The mean serum vitamin D in psoriasis vulgaris patients and controls were 14.36 ± 6.36 and 19.92 ± 7.59 ng/mL, respectively. No psoriasis vulgaris were observed in patients with normal 25(OH)D levels, and only 3 control subjects with normal serum 25(OH)D levels. These results were not statistically significant (p = 0.09). Conclusion: Most patients with psoriasis vulgaris were observed having vitamin D deficiency. However, the prevalence of vitamin D deficiency in the control subjects was high as well. Therefore, there were no differences in serum 25(OH)D levels between psoriasis vulgaris and control patients.
Tinea capitis is the most common fungal infection in children. Recently, the dermoscopic examination of the hair and scalp or trichoscopy has surfaced on and proven to be a very effective, proficient, and efficient useful tool in diagnosing and screening of some hair disorders. Case: A 12-year-old boy presented with circular lesions with sharp margins on the scalp, with breaking hairs forming patches of partial alopecia. Scrapings of the scalp, containing broken hairs, were collected and submitted for direct examination by using KOH preparation revealed chains of arthroconidia covering the hair shaft. Dermoscopic examination was performed and revealed the presence of fine scale, broken hairs and comma hair. Discussion: Our patient reavealed a good clinical improvement evaluated by microscopic examination and dermoscopic evaluation. After effective antifungal therapy for 8 weeks duration, the hair fully regrows. Conclusion: Scalp dermoscopy or “trichoscopy” represents a valuable, noninvasive technique for the evaluation of patients with hair loss due to tenia capitis.
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