Hwang Seon-Wook, Kang Ju-Hyun, Chun Ji-Sung, Seo Jong-Keun, Kim Hyun-Woong, Lee Deborah, Sung Ho-Suk
Department of Dermatology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea.
Ann Dermatol. 2009 Nov;21(4):399-401. doi: 10.5021/ad.2009.21.4.399. Epub 2009 Nov 30.
Syphilitic keratoderma is a rare cutaneous manifestation of secondary syphilis, characterized by symmetrical and diffuse hyperkeratosis of the palms and soles. In addition, no cases of syphilitic keratoderma and uveitis have been reported in the dermatologic literature. A 69-year-old woman presented with steroid-resistant hyperkeratotic patches on the palms and soles and uveitis for 4 months. As steroid-resistant uveitis must be evaluated for syphilis, viral infections, and autoimmune diseases, we ran several laboratory tests and the serologic test for VDRL was reactive (titer; 1:128). After treatment with penicillin G (4 MU, IV every 4 hours for 2 weeks), her skin lesions and visual disturbance were completely resolved. Therefore she was diagnosed as having syphilitic keratoderma and uveitis. Here, we report a rare case of syphilitic keratoderma concurrent with syphilitic uveitis and suggest that evaluation for syphilis may be required when skin lesions and ocular disturbance are resistant to long-term steroid therapy.
梅毒性角化病是二期梅毒罕见的皮肤表现，其特征为手掌和足底出现对称性弥漫性角化过度。此外，皮肤科文献中尚未报道过梅毒性角化病合并葡萄膜炎的病例。一名69岁女性出现手掌和足底的类固醇抵抗性角化过度斑块以及葡萄膜炎4个月。由于对于类固醇抵抗性葡萄膜炎必须评估梅毒、病毒感染和自身免疫性疾病，我们进行了多项实验室检查，梅毒血清学试验VDRL呈阳性反应（滴度为1:128）。经青霉素G治疗（400万单位，静脉注射，每4小时一次，共2周）后，她的皮肤病变和视力障碍完全消退。因此，她被诊断为患有梅毒性角化病和葡萄膜炎。在此，我们报告一例罕见的梅毒性角化病合并梅毒性葡萄膜炎病例，并建议当皮肤病变和眼部障碍对长期类固醇治疗耐药时，可能需要评估梅毒。
