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Nodular late syphilis.

We present an unusual case of nodular late syphilis in a 52-year-old black man who had grouped, violaceous, pruritic papulonodules. Overlapping features of both secondary and teritary stages of the disease were present. The clinical presentation and histopathology are discussed.

Biopsy↗

A mixed infection of syphilis and chancroid.

The clinical differentiation between a hard chancre and a soft chancre is well known to dermatologists. We present a patient with both a hard and a soft chancre developing on the penis. Thorough investigational studies should be made of all patients with venereal disease to determine whether more than one venereal disease is present.

Adult↗

Extragenital syphilitic chancres.

Two patients with extragenital chancres are presented to emphasize unusual expressions of primary syphilis. The clinical presentations and differential diagnosis of extragenital chancres are discussed.

Adult↗

Granulomatous tertiary syphilis.

A 65-year-old woman presented with progressive acute organic brain syndrome and peculiar scarring skin lesions that on biopsy revealed a lymphocytic and granulomatous deep dermal infiltrate. The serologic examination was diagnostic for, and the therapeutic response consistent with, syphilis. This case of tertiary syphilis serves as a reminder of a not-yet-extinct entity.

Aged↗

The clinical spectrum of syphilis in adolescence.

Syphilis, due to the spontaneous healing of the initial lesion, is often overlooked by adolescent patients. If undetected and untreated the condition may bring disastrous consequences. To investigate how syphilis first appears, we reviewed the medical history of 33 patients diagnosed from 1977 to 1981. The following main symptoms were found: typical chancre (9%), atypical chancre (9%), rash (45.5%), and marked lymphadenopathy (12%). Four patients were discovered only by a positive serology; four patients with low titers were discovered to have been previously treated and were monitored for evidence of cure. All patients had a positive RPR and FTA-ABS. Eleven patients (33%) had a concomitant venereal disease or a positive past history. A significant number (48%) were troubled, delinquent, or homosexual; 10% were victims of sex abuse. Contrary to general belief, most patients do not consult for a primary chancre. Instead, they present with a broad spectrum of clinical manifestations ranging from a variety of dermatologic signs to diverse degrees of lymphadenopathy, to being completely asymptomatic. Syphilis was not the initial diagnosis in over one-third of our patients. Those caring for adolescents should maintain a high index of suspicion for this disease.

Adolescent↗

Syphilitic vignettes from Russia.

The data show that syphilis is widespread in the society and may be seen among every age group of population from infants to the elderly. A description of 8 unusual cases of syphilis revealed in Russia during the current epidemic of this disease is discussed, including congenital syphilis, acquired syphilis in children, and malignant syphilis in adults.

Adolescent↗

[Rash and nephrotic syndrome: consider syphilis].

INTRODUCTION: Kidney disease is among the clinical manifestations of secondary syphilis, as this case report shows. OBSERVATION: During serologically confirmed secondary syphilis, a 63-year-old man developed a nephrotic syndrome diagnosed after biopsy as membranous nephropathy. DISCUSSION: Membranous nephropathy is an immunological complication of secondary syphilis. Recovery usually follows treatment. It is often associated with signs that may erroneously suggest connective tissue disease.

Adrenal Cortex Hormones↗

Bilateral secondary syphilis of the tonsil.

A patient with bilateral tonsillar enlargement secondary to syphilis is presented. Clinical appearance, histological findings and serological tests permitted a correct diagnosis to be obtained, ruling out the suspicion of cancer.

Adult↗