关键词: Erythema multiforme HIV cytomegalovirus infection secondary syphilis

Mesh : Anti-Bacterial Agents / administration & dosage therapeutic use Coinfection Condylomata Acuminata / complications Cytomegalovirus / isolation & purification Cytomegalovirus Infections / complications Erythema Multiforme / diagnosis drug therapy HIV Seropositivity / complications Homosexuality, Male Humans Male Papillomaviridae / isolation & purification Penicillin G Benzathine / therapeutic use Syphilis / diagnosis drug therapy Syphilis Serodiagnosis Treatment Outcome Treponema pallidum / isolation & purification

来  源:   DOI:10.1177/0956462418805197   PDF(Sci-hub)

Abstract:
Early syphilis can rarely cause erythema multiforme-type eruptions as well as triggering erythema multiforme (EM). EM-like lesions in secondary syphilis are characterized by clinical features of EM and laboratory tests consistent with secondary syphilis and the skin histology shows predominantly a plasma cell infiltrate with the presence of treponemes. When EM is triggered by early syphilis, the skin histology shows mixed inflammatory cells usually in the absence of treponemes in the skin lesion. There may also be mixed histology with the presence of treponemes in the absence of a plasma cell infiltrate and vice versa. We describe a case of secondary syphilis presenting as EM with bullae and histology showing EM features without a plasma cell infiltrate but positive for Treponema pallidum by immunohistochemical staining. The patient was also coinfected with cytomegalovirus, human immunodeficiency virus, and anal warts. The EM eruptions resolved with treatment for secondary syphilis with benzathine penicillin G.
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