Tan Matthew C Y, Walford Norman, Tan Kok Kuan
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Innoquest Diagnostic Laboratories, Farrer Park Hospital, Singapore.
Oxf Med Case Reports. 2022 Oct 22;2022(10):omac114. doi: 10.1093/omcr/omac114. eCollection 2022 Oct.
Syphilitic chancres are pathognomonic of primary syphilis and can have many atypical presentations. Early detection of such lesions can prevent complications by linking patients to care early. We report a case of a 45-year-old Chinese men who has sex with men (MSM) presenting with a wound on his penis after masturbation. Initial impressions of a frenulum tear secondary to overzealous masturbation led to a circumcision and frenulectomy. Routine histology done provided an unexpected finding of plasma cell infiltrates suggestive of Syphilis. Serology was done to confirm the diagnosis and patient was treated with oral doxycycline for 2 weeks. This case aims to highlight the importance of routine histology during circumcisions especially because lesions such as syphilitic chancres are not always typical in presentation.
梅毒硬下疳是一期梅毒的特征性表现，可有多种非典型表现。早期发现此类病变可通过使患者尽早获得治疗来预防并发症。我们报告一例45岁的男男性行为者（MSM）中国男性病例，其在自慰后阴茎出现伤口。最初认为是过度自慰导致的系带撕裂，遂进行了包皮环切术和系带切除术。常规组织学检查有意外发现，提示梅毒的浆细胞浸润。进行了血清学检查以确诊，患者接受了为期2周的口服强力霉素治疗。该病例旨在强调包皮环切术中常规组织学检查的重要性，尤其是因为梅毒硬下疳等病变的表现并不总是典型的。
