title: Malignant lues in an immunocompetent patient.
abstract: Malignant lues is a rare form of secondary syphilis mostly associated with HIV infection. It is an uncommon presentation of syphilis even rarer in immunocompetent patients. We present the case of a 57-year-old homosexual man referred to our department due to a 4-month history of a disseminated, slightly painful, nodular-ulcerative cutaneous eruption associated with low-grade fever, malaise and aesthenia. Regarding the clinical features and serological and histopathological findings, the diagnosis of syphilis maligna was assumed. Serology for HIV was repeatedly negative. This case is interesting, not only because a very uncommon form of secondary syphilis was identified but also for being diagnosed in an immunocompetent patient. Lack of awareness of this type of presentation delays the diagnosis and treatment, leading to an increase in morbidity and spread of infection.
authors.affiliation: Department of Dermatology and Venereology, Garcia de Orta Hospital, Almada, Portugal alves.joaovitor@gmail.com.
authors.forename: João
authors.initials: J
authors.lastname: Alves
authors.affiliation: Department of Dermatology and Venereology, Garcia de Orta Hospital, Almada, Portugal.
authors.forename: Ana Marta
authors.initials: AM
authors.lastname: António
authors.affiliation: Department of Dermatology and Venereology, Garcia de Orta Hospital, Almada, Portugal.
authors.forename: Diogo
authors.initials: D
authors.lastname: Matos
authors.affiliation: Department of Dermatology and Venereology, Garcia de Orta Hospital, Almada, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Coelho
authors.affiliation: Department of Dermatology and Venereology, Garcia de Orta Hospital, Almada, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Cachão
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D001706:Biopsy; D015658:HIV Infections / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010401:Penicillin G Benzathine / Q000008:administration & dosage* / Q000627:therapeutic use; D012883:Skin Ulcer / Q000473:pathology; D013587:Syphilis / Q000473:pathology; D013591:Syphilis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome; D014210:Treponema pallidum / Q000302:isolation & purification
chemical_list: D010401:Penicillin G Benzathine
keywords: AIDS; HIV; Syphilis (Treponema pallidum); bacterial disease; lues maligna; malignant syphilis; sexually transmitted infection