Hodak E, David M, Rothem A, Bialowance M, Sandbank M
Department of Dermatology, Beilison Medical Center, Petah Tiqva, Israel.
J Am Acad Dermatol. 1987 Nov;17(5 Pt 2):914-7. doi: 10.1016/s0190-9622(87)70280-1.
We hereby report a case presenting a rare form of secondary syphilis with an unusual nodular eruption accompanied by pruritus and generalized lymphadenopathy, bearing a striking resemblance to lymphoma. The histologic picture was also misleading and was compatible with lymphocytoma cutis. The diagnosis was eventually made after results of serologic tests for syphilis were found to be positive, with an extremely high titer of VDRL, and dark-field microscopy had demonstrated spirochetes in a nodular lesion. Secondary syphilis should thus be considered in the differential diagnosis of nodular lesions resembling lymphoreticular disease. It is also suggested that syphilis be added to the list of diagnoses belonging to the category of pseudolymphoma.
我们在此报告一例呈现罕见形式二期梅毒的病例，其伴有不寻常的结节性皮疹、瘙痒及全身淋巴结肿大，与淋巴瘤极为相似。组织学表现也具有误导性，符合皮肤淋巴细胞瘤。最终在梅毒血清学检测结果呈阳性、VDRL滴度极高且暗视野显微镜检查在结节性病变中发现螺旋体后作出诊断。因此，在鉴别诊断类似淋巴网状疾病的结节性病变时应考虑二期梅毒。还建议将梅毒添加到假性淋巴瘤类别的诊断列表中。
