Open AccessPsoriasiform Secondary Syphilis: A Pitfall in Diagnosis
Author(s) -
Satiti Retno Pudjiati,
Rsup Dr. Sardjito Yogyakarta
Publication year - 2021
Publication title -
hsoa journal of clinical dermatology and therapy
Language(s) - English
Resource type - Journals
ISSN - 2378-8771
DOI - 10.24966/cdt-8771/100066
Subject(s) - medicine , dermatology , syphilis , serology , histopathology , psoriasis , physical examination , pathognomonic , skin biopsy , biopsy , surgery , pathology , immunology , disease , human immunodeficiency virus (hiv) , antibody
Secondary syphilis in Acquired Immune Deficiency Syndrome (AIDS) patient’s have variety of skin manifestations. Failure to recognize the manifestations of secondary syphilis can cause delaying the therapy. The recognition of the characteristics of skin lesions as well as serology examination and histopathology help the physicians for making the diagnosis. A 24-year-old male who was diagnosed with HIV previously came with chief complaint of scaly red plaques on the palms and soles. The similar lesions were also notedover the face especially the perioral region.Patient also noted to have also alopecia on the eyebrows and eyelashes. Patient was diagnosed with psoriasis vulgaris from previous physician and treated with unknown therapy. Serological examination revealed reactive TPHA and high titer of VDRL. Skin biopsy was done and it has features of psoriasis but without pathognomonic signs. The patient then was treated with single dose of benzathine penicillin G 2,4 million units which provided excellent improvement.Secondary syphilis is called "great imitator" because of its broad manifestations. It has been widely reported that secondary syphilis has been misdiagnosed as psoriasis and seborrheic dermatitis. Characteristics of the lesion, serological examination and histopathology play significant role in establishing the diagnosis.