Arora Shikha, Dhali Tapan K, Haroon Mohammad A
Department of Dermatology & Venereology, ESIC-PGIMSR, Basaidarapur, New Delhi, India.
Int J STD AIDS. 2013 Nov;24(11):905-7. doi: 10.1177/0956462413495382. Epub 2013 Jul 19.
Syphilis is a sexually transmitted infection with various stages of evolution and a myriad of presentations. To avoid a delay in diagnosis, it is important to recognize secondary syphilis presenting with vesicular lesions. A patient presented with maculopapular rash of recent onset with several vesicles and related the eruption to paracetamol taken one day before. The differential diagnoses considered were drug eruption, pityriasis lichenoides et varioliformis acuta, pityriasis rosea and secondary syphilis. HIV, VDRL (1:256) and TPHA tests were positive and histopathology revealed lymphohistiocytic infiltrate and plasma cells. Thus, a diagnosis of secondary syphilis coexisting with HIV was confirmed. The patient was administered benzathine penicillin and anti-retroviral therapy was started. He responded very well to treatment. We report this case because of the rarity of vesicular eruption in secondary syphilis.
梅毒是一种性传播感染疾病，有不同的演变阶段和众多表现形式。为避免诊断延误，识别出现水疱性皮损的二期梅毒很重要。一名患者近期出现斑丘疹皮疹，伴有数个水疱，并将皮疹发作与一天前服用的扑热息痛联系起来。考虑的鉴别诊断包括药疹、急性痘疮样苔藓样糠疹、玫瑰糠疹和二期梅毒。HIV、VDRL（1:256）和TPHA检测均呈阳性，组织病理学显示淋巴细胞和组织细胞浸润以及浆细胞。因此，确诊为二期梅毒合并HIV感染。该患者接受了苄星青霉素治疗，并开始了抗逆转录病毒治疗。他对治疗反应良好。我们报告这个病例是因为二期梅毒出现水疱性皮疹很罕见。
