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Vesicular syphilid in a seropositive patient
Shikha Arora1, Tapan K Dhali, Mohammad A Haroon
1Department of Dermatology & Venereology, ESIC-PGIMSR, Basaidarapur, New Delhi, India.
International Journal of STD & AIDS
|August 24, 2013
Summary
Recognizing secondary syphilis with rare vesicular lesions is crucial for timely diagnosis. This case highlights a patient with coexisting HIV and syphilis, presenting with a unique vesicular rash.
Area of Science:
- Dermatology
- Infectious Diseases
- Public Health
Background:
- Syphilis, a complex sexually transmitted infection, presents with diverse clinical manifestations across its stages.
- Early diagnosis is essential to prevent complications, yet atypical presentations can cause diagnostic delays.
Observation:
- A patient presented with a maculopapular rash and vesicles, initially attributed to a drug reaction.
- Differential diagnoses included drug eruption, pityriasis lichenoides et varioliformis acuta, pityriasis rosea, and secondary syphilis.
Findings:
- Serological tests revealed positive VDRL (1:256) and TPHA, confirming syphilis.
- Histopathology showed lymphohistiocytic infiltrate and plasma cells, indicative of syphilis.
- Co-infection with Human Immunodeficiency Virus (HIV) was also confirmed.
Implications:
- This case underscores the importance of considering secondary syphilis in patients with atypical vesicular eruptions.
- Prompt diagnosis and treatment with benzathine penicillin and antiretroviral therapy led to a favorable outcome.
- The rarity of vesicular lesions in secondary syphilis warrants increased clinical awareness for this presentation.
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