Stone Courtney E, Onyekaba Ndidi-Amaka, Lucas Matthew, Jukic Drazen
Medicine, Mercer University School of Medicine, Savannah, USA.
Dermatology, Winn Army Community Hospital, Fort Stewart, USA.
Cureus. 2020 Oct 2;12(10):e10774. doi: 10.7759/cureus.10774.
The cutaneous manifestations of secondary syphilis can vary significantly between patients, leading to a more difficult or delayed diagnosis. Here we present an instructive case of secondary syphilis in a 45-year-old, HIV-positive male patient. He presented with a solitary, crusted anterior neck nodule without concomitant systemic symptoms. Together, history and physical exam were concerning for non-melanoma skin cancer. Histopathologic evaluation of the lesion revealed an extensive infiltrate of plasma cells at the dermoepidermal junction, and immunohistochemical staining revealed numerous microorganisms. Physicians must keep syphilis in the differential diagnosis when evaluating atypical nodular lesions resembling non-melanoma skin cancer for the purpose of initiating appropriate antibiotic treatment and preventing future infectious complications.
二期梅毒的皮肤表现患者之间差异很大，导致诊断更加困难或延迟。在此，我们报告一例45岁HIV阳性男性患者的二期梅毒典型病例。他表现为颈部前方有一个孤立的结痂结节，无伴随的全身症状。综合病史和体格检查，怀疑为非黑素瘤皮肤癌。病变的组织病理学评估显示真皮表皮交界处有大量浆细胞浸润，免疫组化染色显示有大量微生物。在评估类似非黑素瘤皮肤癌的非典型结节性病变时，医生必须将梅毒列入鉴别诊断，以便开始适当的抗生素治疗并预防未来的感染并发症。
