Atypical Cutaneous Manifestations in Syphilis

A unique presentation of papulonodular secondary syphilis in an elderly patient

“…Most of the reported cases presented disseminated red‐purple patches, nodules, and plaques, predominantly on the face, trunk, and upper limbs, with sparing of the palmoplantar region. These clinical aspects are different from the ones in our patient, in whom nodular lesions were located on the legs, with palmoplantar brownish macules also being present 1–4 …”

“…The clinical diagnosis of secondary syphilis is challenging, with a florid presentation including papular, follicular, vesicular, corymbiform, psoriasiform, nodular, annular, pustular, or framboesiform skin lesions 2,3 …”

Sífilis anorrectal: una entidad subdiagnosticada. Casuística de un hospital público de la Ciudad Autónoma de Buenos Aires

“…Entre el HIV y otros gérmenes productores de ITS existe un sinergismo biológico, que aumenta dos a tres veces las probabilidades de los individuos con lesiones ulcerativas sifilíticas de adquirir HIV (8). La infección por sífilis disminuye el nivel de CD4 y aumenta la carga viral de HIV (9,10). Las manifestaciones cutáneas de la sífilis en contexto de HIV son más frecuentemente prolongadas, graves y atípicas (11).…”

Gangrene-like cheilitis and pustular eruptions in a patient with secondary syphilis

“…Secondary syphilis is known to have variable clinical symptoms; in particular, symptoms can be atypical in patients with HIV infection. 3 Although various oral manifestations occur in patients with secondary syphilis, the most common presentation consists of slightly elevated plaques and oval-shaped ulcers; gangrene-like cheilitis is uncommon. Similarly, skin lesions usually present as symmetric macular, papular or maculopapular lesions; however, patients sometimes develop pustular lesions.…”

“…Similarly, skin lesions usually present as symmetric macular, papular or maculopapular lesions; however, patients sometimes develop pustular lesions. 3 Syphilis is widespread globally and still imposes a substantial global health burden. 4 Clinicians should be aware of uncommon lesions that can occur in patients with syphilis, not only to achieve appropriate diagnosis and treatment, but also to prevent the spread of infection.…”