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Related Experiment Videos

Horny syphilid.

T A Chapel, D Blum

    Cutis
    |July 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    A man with widespread, wart-like skin lesions was diagnosed with secondary syphilis. This rare presentation, known as horny syphilid, highlights the need for high suspicion and serologic testing for syphilis in dermatology.

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    Area of Science:

    • Dermatology
    • Infectious Diseases
    • Syphilology

    Background:

    • Secondary syphilis is a systemic infection caused by Treponema pallidum, often presenting with diverse mucocutaneous manifestations.
    • Cutaneous eruptions are common in secondary syphilis, but specific morphologies can be rare and challenging to diagnose.
    • The differential diagnosis for palmar and plantar lesions is broad, including infections, inflammatory conditions, and neoplasms.

    Observation:

    • A 37-year-old male presented with numerous, discrete, hyperkeratotic, verrucous papules and plaques on the volar aspects of his hands and feet.
    • The lesions were initially mistaken for common warts (clavi) due to their appearance and location.
    • Physical examination revealed no other significant dermatological findings, and the patient reported no systemic symptoms at presentation.

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    Findings:

    • Serologic tests for syphilis, including Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS) tests, were positive.
    • The clinical presentation and positive serology confirmed the diagnosis of secondary syphilis.
    • The specific morphology of the volar lesions was consistent with the rare entity known as "horny syphilid" or "keratotic syphilid."

    Implications:

    • This case underscores the importance of considering syphilis in the differential diagnosis of unusual cutaneous eruptions, particularly those affecting the palms and soles.
    • High index of suspicion and prompt serologic evaluation are crucial for accurate and timely diagnosis of syphilis.
    • Recognition of rare presentations like horny syphilid can prevent diagnostic delays and ensure appropriate management of infectious diseases.