Primary syphilis due to genital–nipple friction

Abstract

Dermoscopy in one case showed hypopigmented macules having feathery margins. 4 Histopathology revealed a reduced number of melanocytes and melanin pigment in most cases, but one report showed a normal number of melanocytes with macromelanosomes. 5 ASH has been compared with other reticular pigmentary disorders such as Dowling-Degos disease, acropigmentation of Kitamura, acropigmentation of Dohi. Unlike those, macules of ASH are more prominent on margins between dorsal and ventral surfaces of hands and feet, with normal intervening skin.Acral vitiligo can be a differential diagnosis of this condition, but non-progressive lesions in unilateral distribution, unresponsive to treatment in our case, does not favor the diagnosis.Confetti vitiligo presents as speckled depigmented macules of size 1-5 mm. They are usually seen around pre-existing vitiligo patches and are hallmark of rapidly progressing vitiligo. 7 Clinical, dermoscopic, and histological comparison of all differentials are described in Table 1.Previous reports have included ASH in reticular pigmentary disorders. Familial nature of this condition cannot be ascertained as only two reports had a family history. Our case stands apart as the girl has unilateral involvement with family history of vitiligo vulgaris.The etiology of this condition remains elusive. Further reports and genetic workup of speckled hypopigmentation cases may help to unravel the mystery of cause and course of this condition.

A crusted ulcer of the nipple

“…2 To the best of our knowledge, extragenital syphilitic chancres on nipple region have been described in 16 patients (3 females, 13 males) (Table 1). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Bites, nibbles or trauma on the nipple during sexual intercourse were reported in ten patients, [3][4][5][6]9,[11][12][13]15 whilst one patient had had genital-nipple contact 8 and another both nipple bite and nipple-genital contact. 17 Lesions were variably described as erosions, ulcers, and crusted plaques.…”

Ein verkrustetes Ulkus an der Brustwarze

“…Soweit uns bekannt ist, wurden extragenitale syphilitische Schanker im Bereich der Mamille bei 16 Patienten (3 Frauen, 13 Männer) beschrieben (Tabelle 1). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Bei 10 Patienten wurde über Bisse, Knabberspuren oder Traumata an der Mamille nach Geschlechtsverkehr berichtet, [3][4][5][6]9,[11][12][13]15 während bei einem Patienten ein Genital-Brustwarzen-Kontakt 8 und bei einem anderen sowohl ein Biss in die Mamille als auch ein Kontakt von der Mamille mit Genitalien beobachtet wurde. 17 Die Läsionen wurden sowohl unterschiedlich bezeichnet (Erythema mamillosum, Erythema mamillosum Erythema mamillosum), als auch unterschiedlich als Erosionen, Geschwüre und verkrustete Plaques beschrieben.…”