Rash Of Secondary Syphilis Research Articles

Syphilis—An Elusive Diagnosis

Increases in the prevalence of syphilis, along with difficulties in recognizing its various clinical presentations, make it an elusive diagnosis. A primary asymptomatic chancre may go unnoticed. Secondary syphilis rash can masquerade as numerous dermatological conditions. Latent syphilis is asymptomatic. Tertiary syphilis can affect the cardiovascular and neurological systems. Failure to correctly diagnose syphilis in its earlier stages leads to dissemination of infection to sexual partners. A positive screening nontreponemal test is confirmed with a treponemal test. Treatment response is monitored by serologic titers. Sexual contacts must be treated. Diagnosis, treatment, and management are presented for 4 stages of syphilis.

Exclusive palmoplantar maculopatchy lesions in a patient of secondary syphilis

Syphilis, sexually transmitted disease which is caused by spirochete bacterium, Treponema pallidum. It presents with a spectrum of lesions and the signs and symptoms of syphilis vary depending on which of the four stages it presents. One needs a high level of clinical suspicion and keen history taking are required to identify the underlying syphilis, which is very commonly masked as some other cutaneous condition. Many different skin diseases may have lesions with a annular maculo-papular erythematous morphology and scaling, e.g., pityriasis rosea of Gibert, actinic porokeratosis, erythema annulare centrifugum, granuloma annulare, subacute or discoid lupus erythematosus and certain annular variants of psoriasis. Some of these also have palmo-plantar involvement where these need to be differentiated from from the rash of secondary syphilis. The present article addresses a case of solely palmoplantar hyperpigmented lesion without any clinical evidence of secondary syphilis.

Aseptic Syphilitic Meningitis in an HIV-Negative Patient with Concomitant Primary and Secondary Syphilis

Background: Syphilis is a sexually and vertically transmitted disease caused by the Treponema pallidum species. Aseptic syphilitic meningitis (ASM) is a subcategory of neurosyphilis. Neurosyphilis is typically considered a tertiary manifestation of syphilis; however, ASM typically occurs within 6 months of exposure and may be concurrent with the rash of secondary syphilis. Case Presentation: A 58-year-old immunocompetent male presented to the dermatology clinic with an erythematous morbilliform rash that involved his trunk and upper extremities. He was prescribed benzonatate 100 mg 3 weeks prior for cough and was diagnosed with a drug-induced morbilliform rash. The patient was seen 1 month later by urology for a penile ulcer. At his urology appointment, an RPR test was done and resulted positive with a titer of 1:256. He was referred to dermatology again and was noted to have a diffuse, copper-colored maculopapular rash involving the palms and soles. During this appointment, the patient complained of a 4-week headache and was found to have nuchal rigidity. He was admitted for neurosyphilis work up, including CSF and CSF-VDRL examination. His neurologic symptoms improved on IV Penicillin G. Repeat RPR testing at 6 months follow up confirmed adequate treatment and his RPR declined from 1:256 to 1:4. Conclusion: We present a case of ASM in an immunocompetent individual with concomitant primary and secondary syphilis. Dermatologists are trained to recognize the cutaneous manifestations of syphilis, but also should be familiar with the variable presentations of the disease, including the early neurological findings of ASM.

Secondary Syphilis Presenting as a Generalized Lymphadenopathy

The diagnosis of syphilis remains challenging. The absence of classical features of the disease, such as the rash of secondary syphilis or genital lesion, may pose diagnostic difficulties. In this article, we report a case of secondary syphilis in which the clinical syndrome and pattern of fluorodeoxyglucose uptake mimicked malignant lymphoma. This case highlights the importance of thorough history taking including sexual contact. Clinicians should be alert for syphilis-underlying unexplained lymphadenopathy, even in the absence of typical rash or genital lesion.

The rash of secondary syphilis

The Case: A 34-year-old homosexual man was referred to a dermatologist for evaluation of a nonpruritic skin rash. The rash had appeared on his abdomen 3 weeks earlier and, over 1 week, had spread to his entire body. During the first week of the rash, he had visited a walk-in clinic, where he

Syphilis and neurosyphilis in a human immunodeficiency virus type-1 seropositive population: Evidence for frequent serologic relapse after therapy

To describe clinical and treatment aspects of syphilis infection among patients seropositive for the human immunodeficiency virus (HIV). Results of serologic tests for syphilis, CD4+ T-lymphocyte counts, and clinical response to therapy were retrospectively monitored in 100 HIV-infected adults with syphilis from a tertiary-care military HIV program. Of the 1,206 HIV-infected patients, 100 (8.3%) in the cohort had syphilis; 61 patients were treated for active syphilis. Serologic or clinical relapse eventually occurred in 10 of the 56 treated patients (17.9%) with follow-up available; 7 of the 10 who relapsed had previously received high-dose intravenous or procaine penicillin therapy. Relapse occurred more than 12 months after initial therapy in 6 of 10 patients (60%) who experienced relapse; 5 patients experienced multiple relapses. The mean CD4+ T-lymphocyte count was not predictive of relapse. Patients with reactive cerebrospinal fluid (CSF) Venereal Disease Research Laboratory (VDRL) test titers (4 of 7 patients [57%]) or the rash of secondary syphilis (4 of 14 patients [29%]) were at highest risk of subsequent relapse or treatment failure when monitored for an average of 2 years. Standard penicillin regimens, including high-dose intravenous penicillin, transiently lowered serum VDRL titers in nearly all cases, but were sometimes inadequate in preventing serologic and clinical relapse in patients infected with HIV type-1, especially among those with secondary syphilis and reactive CSF VDRL titers. Careful long-term follow-up is essential, and repeated courses of therapy may be needed for patients infected with HIV type-1 who have syphilis.

Secondary Syphilis with Iris Papules

A 30-year-old man developed bilateral iridocyclitis with iris roseolae and papules three months after the rash of secondary syphilis. The inflammation resolved after treatment with penicillin, intramuscularly, topically given corticosteroids, and cycloplegics. The serum immune-complex levels were slightly increased. Iris angiography showed leakage of fluorescein in the region of the papules and roseolae and from the vessels of the pupillary margin. When the eye was clinically uninflamed, a follow-up angiogram showed leakage of fluorescein from the same areas, suggesting that the inflammatory effect on the iris vessels persisted in the region of the roseolae, the papules, and the sphincter vessels.