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Nodular secondary syphilis in a woman.
BMJ Case Rep. 2013 May 08; 2013BC

Abstract

We report the case of a 21-year-old woman with symmetrically distributed, ulcerated nodules and plaques on the face, neck and arms. Initial differential diagnoses included pyoderma or sarcoidosis based on the clinical presentation and histopathology with non-caseating granulomas. After inefficient treatment with topical and systemic fusidic acid and steroids, we diagnosed nodular secondary syphilis owing to positive serology and immunohistochemical staining of Treponema pallidum in lesional skin. After treatment with benzathine penicillin, skin lesions improved and antibody titres declined significantly within 3 months. Nodular skin lesions in secondary syphilis are rare with 15 reported cases within the last 20 years. Furthermore, the granulomatous histology is often misleading. Our patient's case suggests that the physicians should be aware of syphilis as a possible differential diagnosis also in patients outside a high-risk population for sexually transmitted diseases and with an unusual clinical presentation.

Authors+Show Affiliations

Department of Dermatology, University Hospital Zurich, Zurich, Switzerland. glatz.martin@gmx.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23661656

Citation

Glatz, M, et al. "Nodular Secondary Syphilis in a Woman." BMJ Case Reports, vol. 2013, 2013.
Glatz M, Achermann Y, Kerl K, et al. Nodular secondary syphilis in a woman. BMJ Case Rep. 2013;2013.
Glatz, M., Achermann, Y., Kerl, K., Bosshard, P. P., & Cozzio, A. (2013). Nodular secondary syphilis in a woman. BMJ Case Reports, 2013. https://doi.org/10.1136/bcr-2013-009130
Glatz M, et al. Nodular Secondary Syphilis in a Woman. BMJ Case Rep. 2013 May 8;2013 PubMed PMID: 23661656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nodular secondary syphilis in a woman. AU - Glatz,M, AU - Achermann,Y, AU - Kerl,K, AU - Bosshard,P P, AU - Cozzio,A, Y1 - 2013/05/08/ PY - 2013/5/11/entrez PY - 2013/5/11/pubmed PY - 2013/12/16/medline JF - BMJ case reports JO - BMJ Case Rep VL - 2013 N2 - We report the case of a 21-year-old woman with symmetrically distributed, ulcerated nodules and plaques on the face, neck and arms. Initial differential diagnoses included pyoderma or sarcoidosis based on the clinical presentation and histopathology with non-caseating granulomas. After inefficient treatment with topical and systemic fusidic acid and steroids, we diagnosed nodular secondary syphilis owing to positive serology and immunohistochemical staining of Treponema pallidum in lesional skin. After treatment with benzathine penicillin, skin lesions improved and antibody titres declined significantly within 3 months. Nodular skin lesions in secondary syphilis are rare with 15 reported cases within the last 20 years. Furthermore, the granulomatous histology is often misleading. Our patient's case suggests that the physicians should be aware of syphilis as a possible differential diagnosis also in patients outside a high-risk population for sexually transmitted diseases and with an unusual clinical presentation. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/23661656/Nodular_secondary_syphilis_in_a_woman_ L2 - https://casereports.bmj.com/lookup/pmidlookup?view=long&pmid=23661656 DB - PRIME DP - Unbound Medicine ER -