Keratopustular variety of framboesiform syphilis: a case report.

Abstract

SUMMARY An unusual form of secondary syphilis is presented, characterised by eruption of keratopustular syphilides which became confluent on the genitals and on other surfaces of the body. Histologically an intensive intraepidermal multilocular pustule formation was followed by equally intense but incomplete keratinisation. Abundant oozing lesions forced the patient to keep the genitals in a plastic bag which led to the formation of an uncommon, giant condylomatous surface covering the scrotum and penis.

The great imitator revisited: the spectrum of atypical cutaneous manifestations of secondary syphilis

“…A serous crust with epidermal acanthosis infiltrated by neutrophils and dense dermal infiltrate with plasma cells may be seen histologically . Fully formed spongiform pustules may be observed, and endothelial swelling with thrombosis has also been reported …”

“…Importantly, other more easily recognized stigmata of secondary syphilis such as palmoplantar involvement, genital lesions, and lymphadenopathy are often present . In addition to the typical framboesiform appearance, a significant pustular component may also be observed . This should be differentiated from the follicular‐based pustule that represents a primary lesion.…”

“…40 In addition to the typical framboesiform appearance, a significant pustular component may also be observed. 43 This should be differentiated from the follicular-based pustule that represents a primary lesion.…”

“…40 Fully formed spongiform pustules may be observed, and endothelial swelling with thrombosis has also been reported. 39,43 Nodulo-ulcerative secondary syphilis (lues maligna)…”

Solitary framboesiform syphilid on the scalp

“…Although atypical presentations are not uncommon, the framboesiform syphilid has been rarely reported. In previous reports, red‐brown, vegetative, nodular lesions of syphilis with an irregular surface have been referred to as framboesiform or raspberry‐like 1–3 . This raspberry‐like surface also has been described as being warty, and may also be moist, crusted or ulcerated.…”