Department of Dermatology, Ankara University School of Medicine.
Department of Dermatology, Ankara University School of Medicine.
Diagn Microbiol Infect Dis. 2019 Sep;95(1):89-92. doi: 10.1016/j.diagmicrobio.2019.04.009. Epub 2019 Jun 21.
Malignant syphilis (also known lues maligna) is a rare and severe variant of secondary syphilis. It is most commonly seen in patients who are infected with human immunodeficiency virus (HIV), and rarely, it can occur in immunocompetent individuals. The exact mechanism of the development of malignant syphilis is not clear. It could probably be associated with immunosuppression, inappropriate immune response of the host, or virulent strain of Treponema pallidum. Coexistence of immunosuppression and inappropriate immune response may predispose to develop malignant syphilis in HIV-infected patients with immune reconstitution inflammatory syndrome. Herein, we report the first case of malignant syphilis after adalimumab therapy for Crohn's disease due to bariatric surgery and discuss the underlying possible pathogenic mechanisms.
恶性梅毒（也称为梅毒恶性）是二期梅毒的一种罕见且严重的变异。它最常见于感染人类免疫缺陷病毒（HIV）的患者中，在极少数情况下，也可能发生在免疫功能正常的个体中。恶性梅毒发展的确切机制尚不清楚。它可能与免疫抑制、宿主不适当的免疫反应或苍白密螺旋体的毒力株有关。免疫抑制和不适当免疫反应的共存可能使接受减肥手术的克罗恩病接受阿达木单抗治疗的 HIV 感染患者易发生恶性梅毒。在此，我们报告了首例因减肥手术而接受阿达木单抗治疗克罗恩病后发生的恶性梅毒病例，并讨论了潜在的可能发病机制。
