PDF(Pubmed)
Abstract：
Secondary syphilis is known as \"The Great Imitator\". It can mimic numerous diseases clinically and histologically, including erythema multiforme (EM). Coinfection with HIV often makes its manifestations more atypical leading to delays in diagnosis and therapy. A 34-year-old male-sex-male patient who had received coronavirus disease 2019 (COVID-19) vaccine 1 week earlier presented with complaints of slightly pruritic scaly erythematous targetoid plaques and erythematous macules on the trunk and extremities for 6 weeks. Histopathology examination showed basal cell vacuolar degeneration of the epidermis and lymphocytic infiltrates along the dermal-epidermal junction and superficial dermis, consistent with EM. Upon further investigation, syphilis and HIV serology were reactive (VDRL 1: 128, TPHA 1: 40960, CD4+ 461 cells/µl). Lesions improved significantly after a single dose of 2,4-million units of benzathine penicillin intramuscular injection. Secondary syphilis presenting as erythema multiforme (EM)-like eruptions is very rare. Physicians should be aware of this unusual presentation to prevent complications.
摘要：
二期梅毒被称为“伟大的模仿者”。它可以在临床和组织学上模拟许多疾病，包括多形性红斑（EM）。与HIV共同感染通常使其表现更加不典型，导致诊断和治疗延迟。一名34岁的男性男性患者在1周前接种了2019年冠状病毒病(COVID-19)疫苗，主诉躯干和四肢有轻微瘙痒的鳞片状红斑和红斑，持续6周。组织病理学检查显示表皮基底细胞空泡变性和沿真皮-表皮交界处和浅表真皮的淋巴细胞浸润，与EM一致。经进一步调查,梅毒和HIV血清学是反应性的(VDRL1:128,TPHA1:40960,CD4+461细胞/μl)。肌内注射2,4百万单位苄星青霉素后，病变显着改善。表现为多形性红斑（EM）样爆发的继发性梅毒非常罕见。医生应该意识到这种不寻常的表现，以防止并发症。
