Infect Chemother.  2013 Dec;45(4):451-454. 10.3947/ic.2013.45.4.451.

Secondary Syphilis with Nodular Vasculitis Mimicking Behcet's Disease

• Jo J
• Heo ST
• Kim JW
• Kim J
• Yu JR

• KMID: 2170451
• DOI: http://doi.org/10.3947/ic.2013.45.4.451

Abstract

Although, erythema nodosum is a common skin manifestation associated with syphilis, nodular vasculitis is a rare feature. Here, we describe a case of a 22-year-old, human immunedeficiency virus negative, non-immunocompromised man who developed recurrent oral and scrotal ulcers with nodular lesions of the lower extremitie. Behcet's disease was initially suspected, however, his serologic test for syphilis was positive, and he was thus diagnosed with secondary syphilis, with a skin biopsy showing nodular vasculitis. The patient was treated with benzathine penicillin, and the skin lesions disappeared after treatment.

Keyword

Secondary Syphilis; Nodular Vasculitis; Behcet's Disease

MeSH Terms

Biopsy
Erythema Nodosum
Humans
Penicillin G Benzathine
Serologic Tests
Skin
Skin Manifestations
Syphilis*
Ulcer
Vasculitis*
Viruses
Young Adult
Penicillin G Benzathine

Figure

• 

  Figure 1 (A) Multiple elliptical crusted erosions are found on the scrotum. (B) Crops of hyperpigmented tender nodules are located on both shins.

• 

  Figure 2 Centrally oriented black-hued, serpiginous, spirochetal organisms representative of Treponema pallidum are visible on skin biopsy (Warthin-Starry stain, × 200).

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  Figure 3 Hematoxylin and eosin stain shows concentric fibrinoid necrosis of the blood vessels and liquefactive degeneration of the subcutaneous fat layer (A), and granulomatous lobular panniculitis with multinucleated foreign body-type giant cells (B) (×200).

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