The clinical spectrum of syphilitic balanitis of Follmann: report of five cases and a review of the literature

Mainetti, Carlo; Scolari, Francesca; Lautenschläger, S

doi:10.1111/jdv.13802

Cited by 23 publications

(26 citation statements)

References 16 publications

(102 reference statements)

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“… 23 Mainetti et al reported five cases of SBF, and one of the patients also presented a hardened, cord-like area. 24 In the cases of syphilis in the present study, the ulcerations and cicatricial areas were discreet, almost imperceptible or non-existent in most of the 19 cases with a confirmed diagnosis of syphilis ( Figure 2 ).…”

Section: Discussionmentioning

confidence: 49%

Atypical manifestations of recent syphilis: study of 19 cases

Sardinha¹,

Lima²,

Heibel

et al. 2020

Anais Brasileiros de Dermatologia

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Background Syphilis is one of the most common diseases that start with genital ulcers. Aside from the initial, classic ulcerative lesion of syphilis, called hard chancre, atypical presentations are common, with erosions, erythema, edema, balanitis, and other dermatological manifestations. Associated with initial genital lesions, the presence of inguinal adenopathies is frequent, and the presence of hardened and painless lymphangitis on the dorsum of the penis is rare. Objectives To describe atypical penile manifestations in patients with early syphilis. Methods The present study reports patients who developed cord-like lesions on the penis. Results The study included 25 patients with cord-like lesions on the penis; in 19 of those, the diagnosis of syphilis was confirmed. Study limitations Small number of patients included. Conclusions In view of the findings of the present investigation, it is important to emphasize that all patients who present with cord-like lesions on the penis must undergo a rapid test for syphilis, VDRL, serologies for HIV viral hepatitis B and C and, whenever possible, histopathological and Doppler exams.

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Section: Discussionmentioning

confidence: 49%

Atypical manifestations of recent syphilis: study of 19 cases

Sardinha¹,

Lima²,

Heibel

et al. 2020

Anais Brasileiros de Dermatologia

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“…4 To best of our knowledge, less than 100 cases of SBF are reported till date where an erosive balanitis was only mucocutaneous lesion or balanitis preceded, accompanied or appeared later than chancre. 6 In 1975, Lejman and Starzycki published a patient whose balanitis was preceded by the appearance of syphilitic chancre. Probable explanation was, active penetration of Treponema pallidum through the epidermis with an hematogenous origin, and intraepidermal proliferation of this would lead to a massive accumulation of Treponema pallidum bacteria.…”

Section: Discussionmentioning

confidence: 99%

Syphilitic Balanitis of Follmann, A Rare Case Report

Agarwal¹,

Jagati²,

Vadher³

et al. 2021

Nepal J Dermatol Venereol & Leprol

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Syphilitic balanitis of Follmann is a rare presentation of primary syphilis. It can occur before or after the appearance of primary chancre and some time without any associated primary chancre. We are reporting a case of syphilitic balanitis of Follmann, in a 23 years old heterosexual male, who presented with balanitis associated with single indurated lesion over coronal sulcus and few superficial ulcers over prepuce.

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“…SBF represents an uncommon manifestation of primary syphilis, with less than 100 cases reported. 6 Nevertheless, it is probably exceedingly underdiagnosed and overlooked, easily masquerading as an unspecific inflammation of the glans both for the patient and the physician. More important than its frequency, treating SBF represents a golden opportunity for epidemic control.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, any focal or diffusely indurated balanitis should prompt investigation for this syphilitic presentation. 6,7 Penile erosions and enlarged regional lymph nodes may also be present 6,7 and the former may require a HSV PCR test to rule out an herpetic infection. Differential diagnosis should also be made with other far more frequent causes of infectious balanitis or balanoposthitis, such as candidiasis balanoposthitis and Chlamydia trachomatis balanitis, or even dermatoses of inflammatory aetiology, such as Zoon balanitis, eczema or psoriasis, which can usually be ruled out based on the patienth can , medical and sexual history, combined with the clinical observation and mandatory serological tests.…”

Section: Discussionmentioning

confidence: 99%

A Rare Type of Balanitis

Duarte

Rodrigues

Fernandes

2020

SPDV

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Syphilis is an old disease and a major public health concern, which is re-emerging in the western world. Atypical syphi- litic presentations can be challenging to diagnose. We present a 23-year-old, HIV-positive man who has sex with men who presented with a 2-week history of an asymptomatic lesion on the glans. Previous topical and systemic treatments proved unsuccessful. Physical examination demonstrated a slightly indurated, ill-defined erythematous plaque over most of the glans. Enlarged, non-tender, bilateral inguinal lymph nodes were palpable. Serological tests revealed a fourfold increase in the VDRL titre (1:8, previously 1:2). A diagnosis of syphilitic balanitis of Follmann was made and complete resolution was achieved with an intramuscular single dose of benzathine penicillin 2.4 MU. Syphilitic balanitis of Follmann represents an uncommon manifestation of primary syphilis, with less than 100 cases reported. Untrea- ted, it will resolve spontaneously, but the patient will remain highly infectious and at-risk for long-term morbidity. In an era in which the number of syphilis cases is increasing sharply both in Western Europe and the United States, all physicians should be aware for the typical and atypical early syphilitic manifestations as they represent opportunities of paramount importance for treatment and epide- mic control.

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The clinical spectrum of syphilitic balanitis of Follmann: report of five cases and a review of the literature

Abstract: SBF might be seen more frequently than has been described due to misinterpretation. Therefore primary syphilis should be included in the differential diagnosis of balanitis and balanoposthitis.

Cited by 23 publications

References 16 publications

Atypical manifestations of recent syphilis: study of 19 cases

Atypical manifestations of recent syphilis: study of 19 cases

Syphilitic Balanitis of Follmann, A Rare Case Report

A Rare Type of Balanitis

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