Leukoderma Syphiliticum

Secondary syphilis presenting as leucoderma syphiliticum: case report and review

“…Fox 5 was convinced that, “in the majority if not all” cases, the circular or oval patches were indeed “abnormally white”. That was also the impression of subsequent observers 3 , 7 , 10 , 11 . Taylor 3 , after studying “many cases over a period of many years”, was “thoroughly convinced” that syphilis could cause both hypo and hyperpigmented macules in some patients.…”

“…He called leucoderma syphiliticum the former, and pigmentary syphilide the latter, and an illustrative chromo-lithography accompanies his 1885 article 3 . In fact, subsequent authors provided clear evidence of cases in which both hypo and hyperpigmented lesions could be recorded 7 , 11 - 13 .…”

“…Older and current observers have described these cases 8 , 16 . By contrast, other observers recorded that the depigmented areas developed precisely at the corresponding sites of the syphilitic rash 7 , 10 , 18 . A similar pattern seems to emerge from the present case, in which the initial lesions were erythematous.…”

“…The rash rarely disappeared under two years and could be permanent 3 . Available treatments had no effect on its natural history 6 , 7 , 10 . Current case descriptions provide evidence of LS as an early presentation of secondary syphilis.…”

“…Some authors have previously and consistently remarked that LS was usually confined to a limited portion of the skin and that the cervical region, mainly its lateral aspect, was by far the preferred site 1 - 9 . The occurrence of LS at other sites, such as the trunk, flank, face and extremities, was, however, well-recognized 3 , 5 - 7 , 10 , 11 . In sharp contrast, current reports of LS have never mentioned the cervical region.…”