Subject(s)
Chancre , Syphilis , Humans , Adolescent , Chancre/diagnosis , Chancre/drug therapy , Lip , Syphilis/complications , Syphilis/diagnosis , Syphilis/drug therapyABSTRACT
Background: Syphilis is an infectious disease caused by the spirochete Treponema pallidum, transmitted mainly by direct contact with the lesion. Primary syphilis usually presents with a chancre at the site of infection, which is highly contagious and resolves without treatment. The aim of this article is to illustrate an unusual location of a syphilitic chancre, in order to consider this diagnosis within the approach to patients with oral ulcers. Clinical case: a 30-year-old man who presented a dermatosis located in the left labial commissure, characterized by a painless ulcer of 1 cm in diameter of 20 days of evolution. The patient has a history of HIV/AIDS. A punch biopsy of the dermatosis was performed, with a histopathological report compatible with syphilitic chancre and a negative VDRL result. He was treated with penicillin G benzathine showing improvement. Conclusions: Primary syphilis is characterized by the development of the syphilitic chancre, which is the first manifestation of syphilis in up to 60% of cases. Extragenital presentation is rare, with only 12-14% of all cases, and of these between 40-70% occur in the mouth, being the lips the most frequent location. Oral manifestations can represent a diagnostic challenge due to its wide spectrum of clinical presentations.
Introducción: la sífilis es una enfermedad infecciosa causada por la espiroqueta Treponema pallidum, transmitida principalmente por contacto directo con la lesión. La sífilis primaria generalmente se presenta con un chancro en el sitio de la infección, el cual es altamente contagioso y se resuelve sin tratamiento. El objetivo de este trabajo es ilustrar una localización poco común de un chancro sifilítico, ya que conocer la existencia de presentaciones poco frecuentes permitirá favorecer su sospecha al abordar las causas de úlceras orales. Caso o casos clínicos: hombre de 30 años de edad, el cual presenta una dermatosis localizada en la comisura labial izquierda, caracterizada por una úlcera no dolorosa de 1 cm de diámetro de 20 días de evolución. El paciente tiene antecedente de VIH/SIDA. Se realizó biopsia en sacabocados de la dermatosis, siendo el informe histopatológico compatible con chancro sifilítico y resultado de VDRL negativo. Fue tratado con penicilina G benzatínica, con lo que presentó mejoría. Conclusiones: la sífilis primaria se caracteriza por la aparición del chancro sifilítico, el cual es la primera manifestación de la sífilis hasta en el 60% de los casos. La presentación extragenital es rara, con solo un 12-14% de todos los casos y, de estos, entre un 40-70 % se presentan en la boca, siendo los labios la localización más frecuente. Las manifestaciones orales pueden representar un desafío diagnóstico debido a su amplio espectro de presentaciones clínicas.
Subject(s)
Chancre , Skin Diseases , Syphilis , Male , Humans , Adult , Syphilis/diagnosis , Syphilis/drug therapy , Chancre/diagnosis , Chancre/drug therapy , Penicillin G Benzathine/therapeutic use , MouthABSTRACT
Although primary syphilis generally involves the genitalia, literature reports that 12% of chancres are extragenital, with the anus and oral cavity as the most frequent locations. We present hereby a case series of four chancres of the finger observed at the sexually transmitted infection centre of Milan between 2010 and 2021.
Subject(s)
Chancre , Sexually Transmitted Diseases , Syphilis , Anal Canal , Chancre/diagnosis , Chancre/drug therapy , Humans , Syphilis/diagnosis , Syphilis/drug therapySubject(s)
Chancre , Syphilis , Chancre/diagnosis , Chancre/drug therapy , Humans , Male , Middle Aged , Perineum , Syphilis/diagnosis , Syphilis/drug therapySubject(s)
Chancre/diagnosis , Lymphadenopathy/diagnostic imaging , Rectal Diseases/diagnosis , Ulcer/diagnosis , Anti-Bacterial Agents/therapeutic use , Ceftriaxone/therapeutic use , Chancre/drug therapy , Chancre/pathology , Colonoscopy , Doxycycline/therapeutic use , Humans , Lymphadenopathy/drug therapy , Magnetic Resonance Imaging , Male , Middle Aged , Rectal Diseases/drug therapy , Rectal Diseases/pathology , Retreatment , Ulcer/drug therapy , Ulcer/pathologyABSTRACT
We describe a 17-year-old man who developed penile annular and scrotal eczematoid syphilids with penile chancre redux. Dermoscopy showed linear-irregular and hairpin vessels with white scales in annular lesions. Histopathology displayed psoriasiform hyperplasia with perivascular lymphoplasmacytic dermal infiltrate. Rapid plasma reagin and Treponema pallidumparticle agglutination assays were positive. The lesions disappeared after intramuscular benzathine penicillin.
Subject(s)
Chancre/pathology , Syphilis, Cutaneous/pathology , Adolescent , Anti-Bacterial Agents/therapeutic use , Chancre/diagnostic imaging , Chancre/drug therapy , Dermoscopy , Humans , Male , Penicillin G Benzathine/therapeutic use , Penis/diagnostic imaging , Penis/pathology , Scrotum/diagnostic imaging , Scrotum/pathology , Syphilis, Cutaneous/diagnostic imaging , Syphilis, Cutaneous/drug therapy , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Penicillin G Benzathine/administration & dosage , Anti-Bacterial Agents/administration & dosage , Chancre/diagnosis , Chancre/drug therapy , Syphilis/diagnosis , Syphilis/drug therapy , Mouth Diseases/diagnosis , Mouth Diseases/drug therapyABSTRACT
Abstract Background: Colorectal cancer is one of the most common types of cancer and is associated with a high lethality rate. Treatment is multidisciplinary, and neoadjuvant chemoradiation is recommended in locally advanced rectal cancer. About 15% of patients answer favorably to neoadjuvant chemoradiation, so it is important to determine the predictors of response. Objective: To review the results of studies that analyzes the predictors of complete pathological response to neoadjuvant chemoradiation in patients with locally advanced rectal cancer. Search methods: We searched for eligible articles in data bases Pubmed and Scopus, between the 12th and the 20th of March 2020. The following key words were used: "predictors of response", "chemoradiation" and "locally advanced rectal cancer". Selection criteria: Inclusion criteria: Studies including patients with locally advanced rectal cancer, patients receiving neoadjuvant chemoradiation as treatment, studies including predictors of response to neodjuvant chemoradiation, overall survival as an outcome and regarding language restrictions, only articles in English were accepted, only studies published until the 31st of December 2019 were accepted. Main results: Fourteen studies fulfilled the inclusion criteria. Thirteen are cohort studies and one is a clinical trial. Four groups of predictors were defined: blood markers, tumors, histopathological and patients' characteristics. Author's conclusions: During the analysis of the articles, there were several predictors identified as potential candidates for clinical practice, such as high pre neoadjuvant chemoradiation Carcinoembryonic Antigen levels and small post neoadjuvant chemoradiation tumor size. Nevertheless, it is difficult to make definitive conclusions about the most reliable predictors. That is why it is crucial to initiate further studies with standardized cut-off values and a methodology homogenization.
Resumo Introdução: O cancro colorretal é um dos cancros mais prevalentes em Portugal e tem associada uma alta taxa de letalidade. Atualmente, o tratamento é multidisciplinar, e a quimioradioterapia neoadjuvante está indicada no Cancro do Reto Localmente Avançado. Sabe-se que cerca de 15% dos doentes responde favoravelmente à quimioradioterapia neoadjuvante, sendo por isso importante determinar quais os preditores de resposta a este tipo de tratamento. Objetivo: Rever os resultados dos estudos que analisam os preditores de resposta completa à quimioradioterapia em pacientes com Cancro do Reto Localmente Avançado. Métodos de pesquisa: Pesquisamos artigos elegíveis nos bancos de dados Pubmed e Scopus, desde o dia 12 a 20 de Março de 2020. Foram utilizadas as seguintes palavras chave: "preditores de resposta", "quimioradioterapia neoadjuvante" e "Cancro do Reto Localmente Avançado". Critérios de seleção: Critérios de inclusão: Estudos que incluam pacientes com Cancro do Reto Localmente Avançad, pacientes sujeitos a quimioradioterapia neoadjuvante, preditores de resposta à quimioradioterapia, que avaliem a sobrevivência como outcome, escritos em inglês e publicados até dia 31 de Dezembro de 2019. Resultados principais: Catorze estudos preencheram os critérios de inclusão. De todos os artigos, treze são Cohort e um é Clinical Trial. Foram definidos quatro grupos de preditores: marcadores de sangue e caraterísticas do tumor, histopatológicas e dos pacientes. Conclusões dos autores: Durante a análise dos artigos, foram identificados vários preditores como potenciais candidates para a prática clínica, tais como o valor elevado de antigénio carcinoembrionário pré- quimioradioneoaajuvância e tamanho reduzido. Contudo, é arriscado elaborar conclusões concretas relativamente aos preditores mais confiáveis. Por isso, é crucial iniciar novos estudos com valores de cut-off estandardizados e métodos com maior homogeneidade.
Subject(s)
Humans , Male , Female , Rectal Neoplasms , Chancre/drug therapy , Neoadjuvant Therapy , Treatment Outcome , Chemoradiotherapy, Adjuvant , ForecastingABSTRACT
Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum and has shown a significant increase in recent decades. It may be associated with other STIs such as soft chancre or chancroid, which is an uncommon infection in Brazil. The presence of ulcerated genital lesions is associated with a higher risk of HIV transmission. An accurate clinical and laboratory diagnosis of genital ulcer disease is essential for the appropriate treatment of pregnant women, in order to avoid congenital syphilis, a severe complication of mother-to-child vertical transmission. We report the case of a woman in the third trimester of pregnancy with Rollet's mixed chancre and describe the clinical and laboratory diagnosis, as well as the treatment of these diseases in pregnancy. We emphasize the importance of training health professionals on early diagnosis and treatment in order to avoid mother-to-child transmission.
Subject(s)
Chancre/diagnosis , Pregnancy Complications, Infectious/microbiology , Adult , Anti-Bacterial Agents/therapeutic use , Brazil , Chancre/drug therapy , Chancre/pathology , Female , Humans , Infectious Disease Transmission, Vertical/prevention & control , Penicillin G Benzathine/therapeutic use , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Syphilis/diagnosisSubject(s)
Chancre , Chancre/diagnosis , Chancre/drug therapy , Humans , Male , Neck , Sexual and Gender Minorities , Young AdultSubject(s)
Body Modification, Non-Therapeutic/adverse effects , Chancre/diagnosis , Treponema pallidum/isolation & purification , Adult , Body Modification, Non-Therapeutic/psychology , Chancre/drug therapy , Chancre/etiology , Foreskin/pathology , Humans , Male , Penicillin G Benzathine/therapeutic use , Stereotyping , Syphilis SerodiagnosisABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Chancre/pathology , Chancre/diagnosis , Neck/pathology , Penicillin G/administration & dosage , Chancre/drug therapy , Fever/etiology , Polymerase Chain Reaction , Treponema/isolation & purification , Risk-TakingSubject(s)
Breast Diseases/diagnosis , Chancre/diagnosis , Nipples/pathology , Syphilis, Cutaneous/diagnosis , Anti-Bacterial Agents/therapeutic use , Breast Diseases/drug therapy , Cephalexin/therapeutic use , Chancre/drug therapy , Diagnosis, Differential , Humans , Male , Syphilis, Cutaneous/drug therapy , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Chancre/diagnosis , Chancre/drug therapy , Ceftriaxone/therapeutic use , Doxycycline/therapeutic use , Granuloma Inguinale/diagnosis , Granuloma Inguinale/drug therapy , Penicillin G Benzathine/therapeutic use , Chancre/classification , Chancre/complications , Chancre/physiopathology , Fever/complications , Fever/drug therapy , Fever/etiologySubject(s)
Chancre/diagnosis , Chancre/drug therapy , Penicillin G/therapeutic use , Treponema pallidum/isolation & purification , Adult , Enzyme-Linked Immunosorbent Assay , Follow-Up Studies , Homosexuality, Male , Humans , Male , Penis/microbiology , Penis/pathology , Risk Assessment , Serologic Tests/methods , Syphilis/diagnosis , Syphilis/drug therapy , Treatment Outcome , Treponema pallidum/drug effectsSubject(s)
Chancre/complications , Penis/pathology , Adult , Chancre/drug therapy , Granuloma, Pyogenic/etiology , Homosexuality, Male , Humans , MaleSubject(s)
Chancre/diagnosis , Homosexuality, Male , Pharyngeal Diseases/diagnosis , Rectal Diseases/diagnosis , Treponema pallidum/isolation & purification , Adult , Anti-Bacterial Agents/therapeutic use , Chancre/drug therapy , Follow-Up Studies , Humans , Laryngoscopy/methods , Male , Pharyngeal Diseases/drug therapy , Polymerase Chain Reaction/methods , Proctoscopy/methods , Rectal Diseases/drug therapy , Sampling StudiesABSTRACT
We report the case of a 35-year-old homosexual man with previous history of HIV, with primary chacre in the rectum. We believe this paper is significant because the diagnosis of rectal ulcer is more common in recent years, however rectal syphilis is a poorly recognized entity, especially with primary chancre formation.