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[Rheumatic expression of secondary syphilis]
R Roque1, F Vinagre, I Cordeiro
1Serviço de Reumatologia, Hospital Garcia de Orta EPE, Almada, Portugal. raquelroque@sapo.pt
Acta Reumatologica Portuguesa
|November 15, 2012
Summary
Syphilis can mimic rheumatic diseases, presenting uncommon musculoskeletal symptoms. Early diagnosis and penicillin treatment resolved a lupus-like syndrome in a postpartum woman, highlighting the importance of considering syphilis in patients with rash and arthritis, especially with palmoplantar involvement.
Area of Science:
- Infectious Diseases
- Rheumatology
- Dermatology
Background:
- Syphilis, caused by Treponema pallidum, typically presents with diverse clinical manifestations.
- Musculoskeletal complaints in syphilis are infrequent and usually mild, but can occasionally dominate the clinical picture.
Observation:
- A postpartum woman presented with a lupus-like syndrome, including polyarthritis, elevated inflammatory markers, and positive antinuclear antibodies (ANA).
- Physical examination revealed a macular, non-pruritic rash on the trunk, upper limbs, and palms.
Findings:
- Serological tests (RPR and TPHA) were positive, confirming secondary syphilis.
- Treatment with benzathine penicillin resulted in complete resolution of clinical symptoms and ANA negativity.
Implications:
- The case underscores that syphilis can present with symptoms mimicking rheumatic diseases.
- Palmoplantar rash in conjunction with arthritis warrants consideration of syphilis as a differential diagnosis.
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