Biomedical subjects
Publications and source records attributed to K Lejman.
A 25-year-old man developed a rare form of early syphilis with smallpox-like eruptions, mainly in the groins and axillae. Histological examination of the syphilids showed an unusual structure with an exceptional number of Treponema pallidum within the epidermis.
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Malignant syphilitic infections occurring in the same woman at an interval of 38 months is reported. The first infection was diagnosed as secondary papulopustular and ecthymatous syphilis. The reinfection was more severe, taking the form of secondary ulcerative syphilis with fever, general deterioration, and loss of weight. Numerous Treponema pallidum were present in the serum expressed from the papulopustular lesions during the first infection, but they were absent from the secretion expressed from the margins of the ulcerative symphilides during the reinfection. Many treponemes were present in the plasma cell infiltrates in histopathological sections of the biopsy specimens taken from the margin of the ulcers.
Gian keratoacanthoma on the inner surface of the prepuce was observed in a 45-year-old man. First symptoms had appeared three months earlier. The tumour was surgically removed. The main histological features of the tumour were enormous, but relatively regular, acanthosis of rete pegs revealing no similarity to the squamous-cell carcinoma, and an exclusively parakeratottic eleidine-containing central plug. The name parakeratoacanthoma is suggested for this type of tumour.
An unusual form of secondary syphilis is presented, characterised by eruption of keratopustular syphilides which became confluent on the genitals and on other surfaces of the body. Histologically an intensive intraepidermal multilocular pustule formation was followed by equally intense but incomplete keratinisation. Abundant oozing lesions forced the patient to keep the genitals in a plastic bag which led to the formation of an uncommon, giant condylomatous surface covering the scrotum and penis.
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A case of primary syphilitic chancre of the coronal sulcus with subsequent development of syphilitic balanitis of Follmann is described. The histopathological picture and preponderantly intraepidermal localization of T. pallidum in the lesions is discussed.
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