A rare case of a chronic syphilitic gumma in a man infected with human immunodeficiency virus

Abstract

This case study is a reminder that syphilis needs to be considered in the differential diagnosis of unusual presentations involving skin and bone.

The Continued Rise of Syphilis: A Case Report to Aid in Identification of the Great Imitator

“…8,9 Progression to tertiary syphilis takes place between months to years but may be faster (within weeks) with HIV co-infection. 6,10,11 Gummas, an inflammatory response to the syphilis spirochete, are a sequelae of tertiary syphilis that develop one to 46 years after infection, usually within the first 15 years. 7,10 Cutaneous tertiary syphilis is further subdivided into a superficial noduloulcerative type affecting only the skin, and a deeper gummatous type, affecting skin, bone, and liver.…”

“…6,10,11 Gummas, an inflammatory response to the syphilis spirochete, are a sequelae of tertiary syphilis that develop one to 46 years after infection, usually within the first 15 years. 7,10 Cutaneous tertiary syphilis is further subdivided into a superficial noduloulcerative type affecting only the skin, and a deeper gummatous type, affecting skin, bone, and liver. 10,12 The noduloulcerative type is more common, appearing as superficial, flat nodules or plaques that develop a serpiginous configuration resembling granuloma annulare, lupus vulgaris, psoriasis, or sarcoid.…”

“…7,10 Cutaneous tertiary syphilis is further subdivided into a superficial noduloulcerative type affecting only the skin, and a deeper gummatous type, affecting skin, bone, and liver. 10,12 The noduloulcerative type is more common, appearing as superficial, flat nodules or plaques that develop a serpiginous configuration resembling granuloma annulare, lupus vulgaris, psoriasis, or sarcoid. 2,13 These cutaneous lesions are usually asymptomatic, but up to 42% of patients report pruritus.…”

Syphilisinfektion im HNO-Bereich

“…Eine Manifestation der bei Syphilis auftretenden kutanen und mukösen Effloreszenzen ist auch im Bereich der Nase möglich [27,28]. Zudem kann es bei der Syphilis-Infektion zu einer vermehrten nasalen Sekretion kommen [17].…”

“…Zudem kann es bei der Syphilis-Infektion zu einer vermehrten nasalen Sekretion kommen [17]. Im Verlauf ist bei fortschreitender Infektion das Auftreten einer Septumperforation über Entstehung einer Sattelnase bis hin zu einer vollständigen Destruktion der Nase möglich [28,29,30]. Hierbei ist im Unterschied zum Lupus oder zur Tuberkulose auch der knöcherne Septumanteil betroffen [31].…”