Hepatitis and bone destruction as uncommon manifestations of early syphilis. Report of a case

Abstract

We describe a patient with a painful lytic lesion of the clavicle and a granuloma of the liver in late secondary syphilis. The classic "moth-eaten" alopecia of the scalp as well as eyebrows and eyelashes suggested syphilis, although an initial false-negative VDRL test for syphilis (prozone phenomenon) caused a delay in diagnosis. Bone as well as liver involvement in early syphilis may be more common than previously recognized.

Hair and Scalp Manifestations in Secondary Syphilis: Epidemiology, Clinical Features and Trichoscopy

“…SA most commonly affects the scalp, but can affect any region covered with hair such as eyebrows [5,6,7], eyelashes [6,7], beard, chest [8], legs [5], axillae [9], and the pubic area [9]. …”

Liver and Bile Duct Infections

“…306,307,[313][314][315][316] Scattered foci of necrosis may be present in the lobules, sometimes accompanied by inflammation around the central veins and Glisson capsule. 304,307,309,316,317 Granulomatous hepatitis is described in some cases (Fig. 11.25).…”

“…11.25). 310,317,318 Rarely, other patterns can be seen, such as diffuse sinusoidal histiocytic infiltration or postinfantile giant cell hepatitis. 319 Spirochetes are only rarely identified in histologic sections with silver stains, such as Warthin-Starry or Steiner.…”

Liver and Bile Duct Infections

“…200,201,206,207 Scattered foci of necrosis may be present in the lobules, sometimes accompanied by inflammation around the central veins and Glisson's capsule. 201,203,207,208 Granulomatous hepatitis is described in some cases ( Fig. 10-25).…”

“…10-25). 208,209 Spirochetes are only rarely identified in histologic sections with silver stains such as Warthin-Starry or Steiner. 199,204,207 cells.…”