[Clinical manifestations of syphilis in maxillofacial area. Part II]. / Osobennosti klinicheskikh proiavlenii sifilisa v cheliustno-litsevoi oblasti. Chast' II.

The article presents a review of the literature with a description of typical manifestations in the maxillofacial area in secondary, tertiary period of syphilis and the description of photo-images of the authors' clinical observations. In the secondary period of syphilis rashes can be found both on the skin and mucous membranes. In secondary reccurent syphilis the oral cavity is affected in 56% of the cases. Typical manifestations of this period are: roseola, papular and pustular syphilides. In the mouth the most frequently observed manifestation is popular syphilide or erythematous sore throat. The syphilitic papule of the mucous membrane of the mouth is flat, sharply demarcated, gets frequently eroded due to maceration or trauma. This papule is highly contagious element. Pustular syphilides are found mostly on the face and are a manifestation of a malignant course of the disease. Tertiary syphilis is a rare form of infection, which is observed as destructive injuries of organs and systems. The most frequent localization of gummy syphilide is the head. This article is highly revalent due to the high frequency of infection manifestation in maxillo-facial area, oral mucosa, and the high contagiousness symptoms, also affecting children.

Malignant syphilis: ostraceous, ulceronecrotic lesions in a patient with human immunodeficiency virus.

We present a 36-year-old HIV-positive man with a sixweek history of spreading, ulcerative, and necroticcutaneous lesions. Laboratory and histopathologicexamination revealed syphilis. This case of malignantsyphilis, also known as lues maligna, is an uncommonvariant of this sexually transmitted infection. This casehighlights the importance of including malignantsyphilis in the differential diagnosis of patientspresenting with a disseminated ulcerative andnecrotic rash, especially in individuals with HIV.

Atypical Cutaneous Manifestations in Syphilis. / Manifestaciones cutáneas atipícas en la sífilis.

Although the diversity of the clinical manifestations of syphilis is well-known, atypical presentations can also occur. Such atypical presentations are associated with a high risk of transmission as a result of diagnostic confusion and treatment delays owing to the disease's ability to mimic other common skin diseases, deviate from classic clinical presentations, and adopt unique forms. Cases of atypical syphilis have been described most frequently in patients with concomitant human immunodeficiency virus (HIV) infection. Because the incidence of syphilis has been growing over recent years -particularly in patients with HIV co-infection- dermatologists need to be familiar with the less well-known clinical presentations of this venereal disease.

Syphilitic alopecia: a report of 5 cases and a review of the literature.

Syphilitic alopecia occurs in only 4% of patients with syphilis. We present 5 cases of this uncommon manifestation and review the corresponding literature. All of the patients in our series were men aged between 31 and 46 years. The lesions, which were located mainly in the parieto-occipital area of the scalp, manifested as multiple, irregular, nonscarring patches of alopecia that adopted a characteristic patchy moth-eaten pattern. One patient initially presented diffuse alopecia with multiple erythematous scaling lesions. Immunohistochemical staining revealed the presence of numerous spirochetes in the hair follicles in the 2 patients in whom skin biopsy was performed. The lesions improved with treatment in all the patients who attended follow-up. Dermatologists should maintain a high level of clinical suspicion for this uncommon manifestation of syphilis, particularly when it is the only symptom.

Rare Presentation of Umbilical Condyloma.

Syphilis is associated with 3 stages of infection-primary, secondary, and tertiary-each with their own associated clinical findings. Secondary syphilis manifests with condyloma lata and other cutaneous findings, and typically occurs several months after the initial infection. Condyloma lata are primarily found in the genital area, but may also be found in other locations such as the umbilicus, axilla, and neck. This brief report describes an umbilical condyloma lata discovered in a patient with secondary syphilis and HIV co-infection and discusses surgical excision and fulguration as an option for definitive management.

An unusual case of oral condyloma lata.

Cutaneous secondary syphilis presents with various manifestations, including condyloma lata (confluented moist papules). This article reports an unusual case of oral condyloma lata. A 56-year-old man presented with a 2-month history of foreign body sensation and sore throat. Physical examination revealed a hypertrophic, reddish-brown, flat-topped, moist plaque in the right amygdaloid fossa. This raised clinical suspicion of lymphoma. However, further enquiry revealed that the patient had extramarital sexual history with a female sex worker. Rapid plasma regain and Treponema pallidum particle agglutination tests were both positive. The patient's wife was diagnosed with early latent syphilis. Both the patient and his wife were treated with penicillin G benzathine, and the lesion in the male patient disappeared in 2 weeks. To the authors' knowledge, a single condyloma lata in the amygdaloid fossa mimicking lymphoma has not been reported previously. Awareness of the usual manifestations of syphilis can avoid unnecessary biopsy, and early diagnosis and treatment may prevent irreversible complications. Partner notification is very important to reduce the risk of transmission, and persistent or recurrent infection.