Malignant lues in an immunocompetent patient

Area of Science:

• Dermatology
• Infectious Diseases
• Syphilology

Background:

• Malignant lues is a rare, severe manifestation of secondary syphilis.
• It is predominantly observed in individuals with Human Immunodeficiency Virus (HIV) infection.
• Diagnosis in immunocompetent individuals is exceptionally rare.

Observation:

• A 57-year-old homosexual male presented with a 4-month history of a disseminated, nodular-ulcerative skin eruption.
• Symptoms included low-grade fever, malaise, and asthenia.
• Clinical presentation, alongside serological and histopathological findings, led to the diagnosis of malignant lues.

Findings:

• The patient tested repeatedly negative for HIV, indicating an immunocompetent status.
• This case represents a rare occurrence of malignant lues in an immunocompetent host.
• Diagnostic confirmation involved a combination of clinical, serological, and histopathological evidence.

Implications:

• Highlights the importance of considering malignant lues even in immunocompetent patients.
• Emphasizes that lack of awareness can delay diagnosis and treatment of this rare syphilis form.
• Underscores the need for increased clinical vigilance to reduce morbidity and transmission of syphilis.