Tags

Type your tag names separated by a space and hit enter

Malignant syphilis (lues maligna) and concurrent infection with HIV.
Int J Dermatol. 1995 Jun; 34(6):403-7.IJ

Abstract

BACKGROUND

During the past 2 1/2 years we observed six patients who had a reactive serology for syphilis, of which four developed widespread noduloulcerative and two vesiculonecrotic lesions. The purpose was to report the occurrence of lues maligna, a rare form of secondary syphilis, in five patients infected with the human immunodeficiency virus (HIV) and in one patient with risk factors for infection.

METHODS

Tzanck preparations, viral cultures, and skin biopsies were performed to evaluate the etiology of the lesions.

RESULTS

Syphilis serology titers ranged from 1:32 to 1:128 and in one instance was as low as 1:8. Such titers can also be found in patients with the latent form of syphilis. Therefore, confirmation of the clinical diagnosis of lues maligna was dependent on skin biopsies that were compatible with secondary syphilis and negative viral studies that excluded varicella, disseminated varicella-zoster or herpes simplex. Lues maligna takes an aggressive course in HIV-infected patients since four of the patients required hospitalization and the two patients who refused to complete treatment, subsequently developed more severe skin and constitutional symptoms.

CONCLUSIONS

HIV-infected patients are at risk for developing lues maligna. Despite its malignant presentation, lues maligna lesions respond rapidly to treatment with penicillin. Secondary syphilis should be added to the list of diseases known to be more aggressive in HIV-infected patients.

Authors+Show Affiliations

Department of Dermatology, New York Medical College-Metropolitan Hospital Center, NY 10029, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

7657439

Citation

Don, P C., et al. "Malignant Syphilis (lues Maligna) and Concurrent Infection With HIV." International Journal of Dermatology, vol. 34, no. 6, 1995, pp. 403-7.
Don PC, Rubinstein R, Christie S. Malignant syphilis (lues maligna) and concurrent infection with HIV. Int J Dermatol. 1995;34(6):403-7.
Don, P. C., Rubinstein, R., & Christie, S. (1995). Malignant syphilis (lues maligna) and concurrent infection with HIV. International Journal of Dermatology, 34(6), 403-7.
Don PC, Rubinstein R, Christie S. Malignant Syphilis (lues Maligna) and Concurrent Infection With HIV. Int J Dermatol. 1995;34(6):403-7. PubMed PMID: 7657439.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Malignant syphilis (lues maligna) and concurrent infection with HIV. AU - Don,P C, AU - Rubinstein,R, AU - Christie,S, PY - 1995/6/1/pubmed PY - 1995/6/1/medline PY - 1995/6/1/entrez SP - 403 EP - 7 JF - International journal of dermatology JO - Int. J. Dermatol. VL - 34 IS - 6 N2 - BACKGROUND: During the past 2 1/2 years we observed six patients who had a reactive serology for syphilis, of which four developed widespread noduloulcerative and two vesiculonecrotic lesions. The purpose was to report the occurrence of lues maligna, a rare form of secondary syphilis, in five patients infected with the human immunodeficiency virus (HIV) and in one patient with risk factors for infection. METHODS: Tzanck preparations, viral cultures, and skin biopsies were performed to evaluate the etiology of the lesions. RESULTS: Syphilis serology titers ranged from 1:32 to 1:128 and in one instance was as low as 1:8. Such titers can also be found in patients with the latent form of syphilis. Therefore, confirmation of the clinical diagnosis of lues maligna was dependent on skin biopsies that were compatible with secondary syphilis and negative viral studies that excluded varicella, disseminated varicella-zoster or herpes simplex. Lues maligna takes an aggressive course in HIV-infected patients since four of the patients required hospitalization and the two patients who refused to complete treatment, subsequently developed more severe skin and constitutional symptoms. CONCLUSIONS: HIV-infected patients are at risk for developing lues maligna. Despite its malignant presentation, lues maligna lesions respond rapidly to treatment with penicillin. Secondary syphilis should be added to the list of diseases known to be more aggressive in HIV-infected patients. SN - 0011-9059 UR - https://www.unboundmedicine.com/medline/citation/7657439/Malignant_syphilis__lues_maligna__and_concurrent_infection_with_HIV_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0011-9059&date=1995&volume=34&issue=6&spage=403 DB - PRIME DP - Unbound Medicine ER -