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Tertiary syphilis of the face.
G Chung1, G R Kantor, S Whipple
1Hahnemann University School of Medicine, Philadelphia, PA.
Journal of the American Academy of Dermatology
|May 1, 1991
Summary
A rare case of tertiary syphilis, mimicking discoid lupus erythematosus for years, showed a Jarisch-Herxheimer reaction and responded well to penicillin. Post-treatment granulomas suggest a hypersensitivity reaction.
Area of Science:
- Dermatology
- Infectious Diseases
- Syphilology
Background:
- Tertiary syphilis can present with diverse mucocutaneous manifestations.
- Misdiagnosis of syphilis can lead to delayed treatment and complications.
Observation:
- A patient presented with noduloulcerative lesions initially misdiagnosed as discoid lupus erythematosus for many years.
- The patient experienced a Jarisch-Herxheimer-like reaction following treatment initiation.
Findings:
- The noduloulcerative lesions showed a dramatic response to penicillin therapy, even after a long duration of misdiagnosis.
- Histopathological examination revealed post-treatment granulomas, potentially indicative of a hypersensitivity response.
Implications:
- This case highlights the importance of considering syphilis in the differential diagnosis of chronic mucocutaneous conditions.
- Prompt diagnosis and penicillin treatment are crucial for managing tertiary syphilis effectively.
- The presence of post-treatment granulomas warrants further investigation into hypersensitivity mechanisms in syphilis.