Condyloma lata on the ankle: an unusual location

Abstract

A 43-year-old Japanese man presented with reddish nodules on the ankle. The nodules had a yellowish crust and eroded surface. Dermoscopy revealed red to milky-red globules at the periphery and some glomerular vessels in the center and a whitish-pink network, which corresponded to capillary dilatation in the papillary dermis and prominent acanthosis, respectively. These structures were surrounded by a yellowish peripheral structureless area and multiple white, small, round structures in the center, corresponding to the macerated horny layer and keratin plugs. Blood samples were positive for rapid plasma reagin (1:64), Treponema pallidum hemagglutination assay (1:20480), and fluorescent treponemal antibody-absorption (1:1280). A lesional skin biopsy specimen showed irregular acanthosis and papillomatosis. The Warthin-Starry and anti-Treponema pallidum antibody stains on the biopsy specimen revealed many spirochetes in the lower epidermis and the papillary dermis. A diagnosis of secondary syphilis with condylomata lata was made. After one week of treatment with oral benzylpenicillin benzathine hydrate (Bicillin® G granules 400,000 units; Banyu Pharmaceutical Co., Ltd, Tokyo, Japan), 1.6 million units (U) daily, the ankle lesions had resolved with a small ulcer and pigmentation. Although syphilis is a relatively common disease, this case study reports an unusual presentation as well as dermoscopy findings.

Condyloma latum of the plantar foot: Case report of an unusual manifestation of secondary syphilis

“…7,15–17 Additionally, there have been single case reports of condyloma lata presenting on the ankle and the palm. 18–19 There have not been any published reports of condyloma lata presenting on the plantar foot, as in our case. Furthermore, our case was unusual in that the patient lacked other cutaneous manifestations of secondary syphilis.…”

Secondary syphilis with extra-genital condyloma lata: A case report and review of the literature

“…Thirty-five papers (from 1940 to 2021) for a total of 42 cases describing an extra-anogenital localization of condyloma lata were found and are summarized in Table 1. 8,10–44 The following localizations were described: toe webs, umbilicus, oral cavity, face, ankle, axillae, plantar and palmar area, popliteal fossa, neck and trunk. Overall, the toe web localization was the most documented (26.2%), with the third interdigital space as the most involved site.…”

“…Dermoscopy can be helpful too: red to milky-red globules, glomerular vessels and a whitish pink network can be observed on the raised border, while a yellowish structureless area and multiple, white, small, round structures can be seen in the center of the lesion. 8–9…”

Secondary Syphilis Presenting As Palmoplantar Psoriasis

“…Condylomata lata is another typical presentation of secondary syphilis. It consists of flat eroded papules, usually localised in the genital areas, even if extragenital occurrences have been described [ 14 , 15 ]. More rarely, lue malignant (nodular-ulcerative syphilis) has been described.…”