Hinnen U, Elsner P, Barraud M, Burg G
Department of Dermatology University of Zurich, Switzerland.
Genitourin Med. 1997 Dec;73(6):577-8. doi: 10.1136/sti.73.6.577.
We report a patient who presented with the suspected diagnosis of syphilis. Clinical findings included a penile ulcer, positive history of syphilis more than 20 years ago, and positive syphilis serology (TPHA, FTA-Abs). A biopsy showed a plasma-cell rich inflammation with granuloma formation. Since a birefractory structure was observed in the biopsy possibly corresponding to a foreign body, the patient's occupational exposure was investigated. Working in the fiber reinforced plastics industry, he was heavily exposed to glass fibre that was even detected on the inside of his underwear. Taking the serological pattern into account that was not consistent with active syphilis, a penile ulcer following a foreign body reaction was diagnosed. This case report demonstrates the difficulties of differentiating foreign body granuloma of the genital region from venereal diseases with granuloma formation.
我们报告了一名疑似梅毒诊断的患者。临床发现包括阴茎溃疡、20多年前的梅毒阳性病史以及梅毒血清学阳性（TPHA、FTA-Abs）。活检显示有富含浆细胞的炎症并形成肉芽肿。由于在活检中观察到一种可能对应于异物的双折射结构，因此对该患者的职业暴露情况进行了调查。他在纤维增强塑料行业工作，大量接触玻璃纤维，甚至在其内衣内侧都检测到了玻璃纤维。考虑到血清学模式与活动性梅毒不一致，诊断为异物反应后出现的阴茎溃疡。本病例报告展示了区分生殖器区域异物肉芽肿与伴有肉芽肿形成的性传播疾病的困难。
