Nguyen Christopher N, Shaw Fiona M, Li Monica M, Blalock Travis W
School of Medicine, Baylor College of Medicine, Texas, USA.
Dermatol Online J. 2022 Oct 15;28(5). doi: 10.5070/D328559250.
We describe an HIV-negative 43-year-old woman presenting with a diffuse ulceronodular eruption and positive serological tests for syphilis consistent with lues maligna. Lues maligna is a severe and rare variant of secondary syphilis characterized by prodromal constitutional symptoms followed by the formation of multiple well-circumscribed nodules with ulceration and crust. This case depicts a particularly rare presentation as lues maligna usually involves HIV-positive men. The clinical presentation of lues maligna can pose a diagnostic challenge, with infections, sarcoidosis, and cutaneous lymphoma as just a few entities in its broad differential diagnosis. However, with a high index of suspicion, clinicians can diagnose and treat this entity earlier and reduce morbidity.
我们描述了一名43岁的HIV阴性女性,她出现弥漫性溃疡结节性皮疹,梅毒血清学检测呈阳性,符合恶性梅毒。恶性梅毒是二期梅毒的一种严重且罕见的变体,其特征为先兆性全身症状,随后形成多个边界清晰的结节,并伴有溃疡和结痂。该病例呈现出一种特别罕见的表现,因为恶性梅毒通常累及HIV阳性男性。恶性梅毒的临床表现可能带来诊断挑战,在其广泛的鉴别诊断中,感染、结节病和皮肤淋巴瘤只是其中几个需要鉴别的疾病。然而,凭借高度的怀疑指数,临床医生可以更早地诊断和治疗这种疾病,并降低发病率。