Condylomata Lata Research Articles

Concomitant primary and secondary syphilis: a case series from a reference center in Mexico

Primary syphilis is characterized by the presence of a chancre and secondary syphilis by the presence of syphilis. The presence of chancres within secondary syphilis have been reported, however, this form of presentation is rare. Patients with synchronous diagnosis of primary and secondary syphilis were included. They underwent a reverse sequence algorithm for syphilis diagnosis with a rapid syphilis test, if positive, a rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) tests were performed. A total of 15 patients were included. All were men. In primary syphilis, penile chancre predominated in 13 patients (86.6%), and one (6.7%) was in the tongue. In secondary syphilis syphilitic roseola was the most common type of presentation in 10 patients (66.6%), followed by the palmoplantar plaques in 6 patients (40%) and condyloma lata in 2 patients (13.3%). One patient presented alopecia in a “moth-eaten” pattern and this presentation coexisted with a condyloma lata and the palmoplantar plaques. Other patient presented with syphilitic roseola, palmoplantar plaques and condyloma lata. Clinical presentation as coexistent primary-secondary syphilis will become more frequent. First contact physicians and dermatologists would have to take more in consideration infrequent and atypical clinical forms of this disease.

Syphilis: Is it Back with a Bang?

Syphilis was brought under control with the advent of penicillin. However, in recent times, a rise in the incidence of syphilis has been reported by Centers for Disease Control and Prevention (CDC). To study the clinical and epidemiological profile of patients with syphilis attending sexually transmitted infection (STI) clinic at tertiary care center. Observational, cross-sectional analysis of sociodemographic, clinical, and investigational data of all syphilis patients visiting STI clinic from August 2019 to July 2021 was done and analyzed. Out of 1330 STI patients that attended the clinic, 15.04% (n = 200) were diagnosed with syphilis, among them 72% (n = 144) were males, and 28% (n = 56) were females, with male-to-female ratio of 2.5:1. Of these 24.5% (n = 49) had primary, 44.5% (n = 89) had secondary, 30.5% (n = 61) had latent, and 0.50% (n = 1) had congenital syphilis. Among secondary syphilis patients, rash was the most common presentation seen in 43 patients, followed by condyloma lata in 30, palmoplantar syphilis in 17, oral mucous patch in 3, and iridocyclitis in 3 patients. Human immunodeficiency virus (HIV) was positive in 16.5% (n = 33). Herpes genitalis was the most common coinfection among 25 patients who were diagnosed with mixed venereal disease. RPR titer was positive in all 200 patients, with 1:16 titer being most common. India is experiencing a new trend in the prevalence of syphilis, mainly due to the changes in risk behavior, misconceptions, and social stigma associated with STIs, improved laboratory diagnosis, and increased public awareness. Particularly secondary and latent stages have shown a rising trend over the past few years. Awareness about safe sexual practices and contraception is very important to control the current resurgence.

Secondary syphilis in a 13-year-old Indonesian girl: a social problem

Introduction: Secondary syphilis is characterized by skin and mucous eruptions, such as condyloma lata. Syphilis cases are rare in children. Several factors could influence sexually transmitted infections (STIs) in children, such as lack of knowledge of STIs, parenting, social environment, parents’ marital status, occupation, and education. We reported one social case of secondary syphilis in a 13-year-old girl. Case Presentation: We did history taking, physical, and laboratory examinations. From history taking, the patient did not know about the signs and symptoms of STIs, has bad parenting, a bad social environment, divorced parents, and parents’ low education. On physical examination, there were skin-colored papules, plaques, and nodules on the labia majora, minora, and perianal. The venereal disease research laboratory (VDRL) result was reactive. The patient was treated with single dose injection of 2.4 million international units benzathine penicillin G and was educated for signs, symptoms, and complications of STIs, and the danger of risky sexual behavior. There were improvement of the lesions 10 days after therapy, decreased of VDRL titer 4x in one month after therapy, and no longer have sexual activity. Conclusion: Social condition can cause STIs in children. The bigger scope of education programs for children is needed to prevent STIs.

Evaluation of Demographic and Clinical Characteristics of the Patients with Syphilis Who Applied to the Dermatology Clinic of a Tertiary Referral Hospital Between the Years 2019-2023

Aim: The aim of this study is to evaluate the demographic and clinical features of syphilis patients followed up in a tertiary referral hospital, and thus to provide current contributions to epidemiological data related to syphilis. 
 Material and Methods: The demographic characteristics, clinical and laboratory findings, and treatments received of all patients diagnosed with syphilis and followed up in our clinic between January 2019 and June 2023 were evaluated retrospectively.
 Results: We included a total of 118 patients, 24 women and 94 men. The average age of the patients was 36.56±5.1 years. Forty-one of the patients (34.7%) were married, 56 were single (47.4%) and the marital status of 21 (17.8%) was unknown. Sixty-two of the patients (52.5%) had primary syphilis , 29 (24.6%) had secondary syphilis and 27 (22.9%) had latent syphilis. When the patients' admission symptoms were evaluated, genital chancre was found in 58 (49.1%), roseola syphilitica in 24 (20.3%), mucous plaque in 11 (9.3%), condyloma lata in 7 (5.9%) and syphilis papulosa psoriasiformis in 3 (2.5%) patients. Twenty-five patients (21.1%) were asymptomatic. Transmission from spouse was in 14 (11.9%) patients while suspicious sexual contact was in 77 (65.3%) patients. The source of transmission was unknown in 27 (22.9%) patients. Response to treatment was obtained in all of the patients who were not lost to follow up. Twenty-two of the patients (18.64%) were HIV positive. 
 Conclusion: Rising syphilis incidence which is observed globally in the recent years indicates the need to raise the level of public awareness about the disease and its transmission routes. In addition, since it can mimic many diseases, it should always be considered in the differential diagnosis, especially in patients with a history of suspicious sexual contact. It is necessary to investigate other sexually transmitted diseases, especially HIV, in patients diagnosed with syphilis.

Vulvar condyloma lata as a first presentation of syphilis.

Vulvar condyloma lata as a first presentation of syphilis.

An Atypical Cutaneous and Histopathological Manifestation of Secondary Syphilis in an HIV-Positive Male: A Case Report

We present an atypical case of secondary syphilis concomitant with condyloma lata in an HIV-positive male. The patient presented with lesions on his lateral neck, soles, and palms. Spirochetes were examined on the biopsy of the palm, consistent with secondary syphilis, but not on the biopsy from the neck. The lesion on the neck was diagnosed as an evolving secondary syphilis lesion due to the extent of the lymphoplasmacytic infiltration, presence of acanthosis and epidermal hyperplasia, the accompanying diagnosis of secondary syphilis on the palm, the patient’s history of HIV, and the related diagnosis of condyloma lata on the dorsal shaft of the penis. Following this diagnosis, the patient was referred to an infectious disease specialist who treated him with a single intramuscular injection of 2.4 million units of benzathine penicillin, per CDC guidelines. This case highlights the importance of clinicians taking into consideration a variety of factors when diagnosing and treating cutaneous disorders with a broad-spectrum differential diagnosis, particularly in at-risk individuals.

Artículo traducido] Condiloma lata y erupción papular de sífilis secundaria

Artículo traducido] Condiloma lata y erupción papular de sífilis secundaria

Oral doxycycline in HIV-related synchronous malignant syphilis and condyloma lata.

Oral doxycycline in HIV-related synchronous malignant syphilis and condyloma lata.

Translated article] Condyloma Lata: A Useful Sign Pointing to a Diagnosis of Secondary Syphilis

Translated article] Condyloma Lata: A Useful Sign Pointing to a Diagnosis of Secondary Syphilis

Condilomata Lata as Clinical Manifestation of Secondary Syphillis In Pregnancy: Study Case Report

The bacterium Treponema pallidum, which causes the infectious disease syphilis, assaults people. Syphilis is a chronic, systemic disease that can affect all regions of the body, can remain dormant for years, is communicable, and can be treated. One of the symptoms of secondary syphilis is condyloma lata. The most typical location is in warm, muggy climates. We describe case G1P0A0, a 29-year-old woman who is 28 weeks pregnant. The patient's main complaint upon arrival was that he had been developing larger and more frequent warts on his genitalia for the past month. The patient, who has only ever been married once, denies having had any previous relationships with men other than her husband. The patient's husband allegedly had sex with prostitutes without wearing a condom in 2021 and admitted to having previously experienced genital injuries in November of that same year but choosing not to seek medical attention.
 Her vital signs and overall status were within normal ranges, and she appeared to be in good health. Multiple 2 cm grey circular plaques with a localized status were found on the labia majora. A VDRL serological examination was performed as a follow-up examination on June 16; the results were reactive.
 At 28 weeks of gestation, the patient was diagnosed with secondary syphilis in the form of condyloma lata based on the history, physical examination, and supportive examination. Erythromycin 500 mg 4x1, paracetamol 500 mg for pain, and a 0.9% NaCl compress were administered to the patient as treatment. Reevaluated after the first month. The VDRL test yielded a titer of 1: 16 and the complaints of lumps in the genitalia had vanished. The patient is advised to have the exam redone in three, six, twelve, and twenty-four months.

Condylomata Lata and Papular Rash of Secondary Syphilis

Condylomata Lata and Papular Rash of Secondary Syphilis

Sexual abuse leading to secondary syphilis in an intellectually disabled person: a case report

<p class="abstract">Syphilis is a sexual transmitted infection (STI) caused by a spirochete, <em>Treponema pallidum</em>. Condylomata lata is a characteristic lesion seen in secondary syphilis. Here we reported a case of 24 year old unmarried male with intellectual disability who presented with condyloma lata over the scrotum, prepuce and perianal region and with moth eaten alopecia over scalp since 1 month. Here the patients mother revealed he had promiscuous relationship with multiple friends, which is a sexual abuse since the patient is intellectually disabled. Clinically diagnosed as secondary syphilis. Venereal disease research laboratory (VDRL) test titre was reactive at 1:32 and <em>Treponema pallidum </em>hemagglutination test (TPHA) was positive. Biopsy was also done, which confirmed diagnosis. Single dose of injection benzathine penicillin G, 2.4 million units was administered intramuscularly. Patient did not develop a Jarisch-herxheimer reaction. On follow up his lesions healed and VDRL titres also came down and non-reactive at 3 months. Here in this case sexual abuse lead to secondary syphilis since patient was intellectually disabled so he couldn’t address his complaints clearly. Hence counselling was done to the patient and family members by dermatologist and psychiatrist.</p><p class="abstract"> </p>

High prevalence of syphilis in women, minors and precarious patients: a cross-sectional study in a Reunion Island sexually transmitted infection clinic, 2017-2020.

Syphilis is a sexually transmitted infection (STI) with a global prevalence estimated at 0.5% in 2012. Syphilis has been on the rise among men who have sex with men (MSM) in high-income countries and remains at endemic levels in low- and middle-income countries. This trend, however, has not been observed in Reunion Island. To determine the prevalence, clinical characteristics and risk factors of syphilis in at-risk patients visiting the South Reunion STI clinic in Reunion Island. This monocentric cross-sectional study included all patients who visited our STI clinic between 2017 and 2020. Syphilis serology was performed on all included patients, and data were collected using a standardized self-administered questionnaire. Over the 3-year study period, 2593 patients were enrolled. The prevalence of syphilis was 7.52% (n=195, 95% CI, 6.50-8.65%) in the overall study population, 11.76% (n=18, 95% CI, 6.97-18.59%) in minors (aged under 18years) and 36.36% (n=16, 95% CI, 21-59%) in pregnant women. The risk factors identified in multivariate analysis were being female [adjusted Prevalence Ratio (aPR) 1.85, 95% CI, 1.10-3.11], being MSM (aPR 2.87, 95% CI, 1.71-4.80), being aged under 18years (aPR 3.54, 95% CI, 1.90-6.57), living in precarious conditions [aPR 3.12, 95% CI, 2.11-4.62] and being born in Reunion Island (aPR 2.43, 95% CI, 1.42-4.13). The clinical presentation was heterogeneous (plaques and papules, chancre, atypical ulcerations, multiple ulcerations, condyloma lata, etc.). These findings suggest a high prevalence of syphilis in at-risk patients visiting our STI clinic. Unlike the situation in other high-income countries, the people most at risk of syphilis in Reunion Island are local-born residents, minors, women and precarious patients. This is a source of concern, especially given the risk of resurgence of congenital syphilis on the island.

An unusual case of oral condyloma lata

Cutaneous secondary syphilis presents with various manifestations, including condyloma lata (confluented moist papules). This article reports an unusual case of oral condyloma lata. A 56-year-old man presented with a 2-month history of foreign body sensation and sore throat. Physical examination revealed a hypertrophic, reddish-brown, flat-topped, moist plaque in the right amygdaloid fossa. This raised clinical suspicion of lymphoma. However, further enquiry revealed that the patient had extramarital sexual history with a female sex worker. Rapid plasma regain and Treponema pallidum particle agglutination tests were both positive. The patient’s wife was diagnosed with early latent syphilis. Both the patient and his wife were treated with penicillin G benzathine, and the lesion in the male patient disappeared in 2 weeks. To the authors’ knowledge, a single condyloma lata in the amygdaloid fossa mimicking lymphoma has not been reported previously. Awareness of the usual manifestations of syphilis can avoid unnecessary biopsy, and early diagnosis and treatment may prevent irreversible complications. Partner notification is very important to reduce the risk of transmission, and persistent or recurrent infection.

Diagnosis through the mouth: Oral condyloma lata as an isolated finding of secondary syphilis

Diagnosis through the mouth: Oral condyloma lata as an isolated finding of secondary syphilis

Umbilical condyloma lata

Condyloma lata, a cutaneous manifestation of secondary syphilis, usually appear as verrucous papules and plaques in the anogenital area. Involvement of the umbilicus is very uncommon. Thus, awareness of this presentation, along with appropriate history, physical exam, and laboratory testing may aid clinicians in prompt and accurate diagnosis. We describe a patient with an unusual presentation of condyloma lata on the umbilicus.

Case report of secondary syphilis in a fifteen year old boy

Syphilis is a sexual transmitted infection caused by a spirochete, Treponema pallidum. We report a case of a fifteen-year-old boy with secondary syphilis. A boy from a poor socioeconomic background presented with a non-healing growth on his penis of about one-month duration. On examination, a condylomata lata was found on the inner aspect of the prepuce, which is a clinical feature of secondary syphilis. He had generalized lymphadenopathy, but had no other clinical features of secondary syphilis. His Venereal Disease Research Laboratory (VDRL) test titre was reactive at 1:128. The Treponema Pallidum Particle Agglutination (TPPA) test was strongly positive, confirming the diagnosis of a treponemal infection. The recommended treatment of a single dose of benzathine penicillin, 2.4 million units was administered intramuscularly. He did not develop a Jarisch–Herxheimer reaction. The lesion on his penis healed within a week of treatment. Follow up VDRL titres were 1:8, 1:4, 1:2 and non-reactive at three months, six months, one year and two years, respectively. Though this was clearly a case of child sexual abuse, the legal system could not be activated because the child categorically denied being abused or having any form of sexual contact.

Retrospective analysis of burden of maternal syphilis and the outcome in the fetus in a tertiary care centre

<p class="abstract"><strong>Background:</strong> Syphilis in pregnancy has its own significance with regards to the outcome of pregnancy. In the meanwhile, it also reflects the effectiveness of health system in the community.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was carried out in a tertiary care centre in Chennai between January 2014 and July 2015 to determine the seroprevalence of syphilis in pregnant women. A total of 4423 ANC mother attending the hospital were included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of the 4423 cases studied, 7 cases were found to be positive for RPR accounting to the prevalence of 0.15%. One mother was symptomatic, presenting with condyloma lata. TPHA was positive in 2 cases (28.5%) Most common association was with HIV infection, 2/7 (28.5%). All the RPR positive patients were treated with tablet erythromycin 500 mg qid × 14 days. Epidose for the partner was given. The outcome was uneventful except for one. A single case of congenital syphilis was reported.</p><p class="abstract"><strong>Conclusions:</strong> Though the prevalence of RPR positive in routine screening is less, the outcome of single congenital syphilis is worrisome. To conclude, although the prevalence of syphilis (0.1%) is low, routine screening of asymptomatic ante natal women is recommended to reduce the incidence of congenital syphilis & perinatal complications and it is always better to treat the ANC mothers with syphilis with Penicillin, preferably with a second dose also.</p>

Condylomata lata on the ankle: an unusual location.

A 43-year-old Japanese man presented with reddish nodules on the ankle. The nodules had a yellowish crust and eroded surface. Dermoscopy revealed red to milky-red globules at the periphery and some glomerular vessels in the center and a whitish-pink network, which corresponded to capillary dilatation in the papillary dermis and prominent acanthosis, respectively. These structures were surrounded by a yellowish peripheral structureless area and multiple white, small, round structures in the center, corresponding to the macerated horny layer and keratin plugs. Blood samples were positive for rapid plasma reagin (1:64), Treponema pallidum hemagglutination assay (1:20480), and fluorescent treponemal antibody-absorption (1:1280). A lesional skin biopsy specimen showed irregular acanthosis and papillomatosis. The Warthin-Starry and anti-Treponema pallidum antibody stains on the biopsy specimen revealed many spirochetes in the lower epidermis and the papillary dermis. A diagnosis of secondary syphilis with condylomata lata was made. After one week of treatment with oral benzylpenicillin benzathine hydrate (Bicillin® G granules 400,000 units; Banyu Pharmaceutical Co., Ltd, Tokyo, Japan), 1.6 million units (U) daily, the ankle lesions had resolved with a small ulcer and pigmentation. Although syphilis is a relatively common disease, this case study reports an unusual presentation as well as dermoscopy findings.

Pre-natal diagnosis of congenital syphilis; a case report

A sixteen-year-old unmarried primigravida was referred from General hospital Hambantota to Teaching hospital, Ragama for specialized management of foetal anaemia and ascites at 32 weeks of gestation. She was diagnosed as secondary syphilis with condylomata lata lesions and had a VDRL titre of R:16 and treated with one dose of intramuscular Benzathine penicillin two days prior to transfer. Ultrasound scan was suggestive of foetal hydrops. Foetal anaemia was suspected and intrauterine transfusion of packed red cells performed successfully. Foetal blood was drawn during the procedure for VDRL and haemoglobin for the diagnosis of congenital syphilis and anaemia respectively. Despite maternal antibiotic treatment and intrauterine management of foetal complications, intrauterine death occurred at 33 weeks of gestation. Sri Lanka Journal of Sexual Health and HIV Medicine Vol.1 2015: 37-40