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Nodular secondary syphilis

M Papini1, A Bettacchi, A Guiducci

  • 1Dipartimento delle Specialità Medico-Chirurgiche, University of Perugia, Italy.

The British Journal of Dermatology
|June 26, 1998
PubMed
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Nodular secondary syphilis presented with multiple skin lesions but no mucous membrane involvement. Histopathology revealed sarcoid-like granulomas, and diagnosis was confirmed by serology and penicillin response.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Pathology

Background:

  • Secondary syphilis can manifest with diverse cutaneous presentations.
  • Nodular syphilis is a rare form, often challenging to diagnose.
  • Distinguishing it from other granulomatous conditions is crucial.

Observation:

  • A 23-year-old Indian man presented with numerous papular, nodular, and plaque-like skin lesions.
  • Mucous membranes were unaffected.
  • Histopathology demonstrated sarcoid-like granulomas composed of lymphocytes, histiocytes, eosinophils, plasma cells, and multinucleated giant cells.

Findings:

  • The histopathological findings mimicked other granulomatous diseases.
  • Differential diagnoses included deep mycoses, leprosy, tuberculosis, sarcoidosis, and lymphoma.

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  • Serological tests and a prompt response to penicillin confirmed secondary syphilis.

    • Implications:

    • This case highlights the importance of considering syphilis in the differential diagnosis of nodular skin lesions.
    • Accurate diagnosis relies on a combination of clinical presentation, histopathology, serology, and therapeutic response.
    • Early diagnosis and treatment of secondary syphilis are essential to prevent complications.