title: Malignant syphilis in an AIDS patient.
abstract: Malignant syphilis is an uncommon, but not unknown, ulcerative variation of secondary syphilis. The lesions typically begin as papules, which quickly evolve to pustules and then to ulcers with elevated edges and central necrosis. It is usually, but not mandatory, found in patients with some level of immunosuppression, such as HIV patients, when the TCD4(+) cell count is >200 cells/mm(3). Despite the anxiety the lesions cause, this form of the disease has a good prognosis. The general symptoms disappear right after the beginning of treatment, and lesions disappear over a variable period. This study reports the case of a 27-year-old man who has been HIV positive for 6 years, uses antiretroviral therapy incorrectly, has a TCD4(+) cell count of 340 cells/mm(3), a VDRL of 1:128 and itchy disseminated hyperchromic maculopapular lesions with rupioid crusts compatible with malignant syphilis.
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio De Janeiro, RJ, Brazil.
authors.forename: T R
authors.initials: TR
authors.lastname: dos Santos
authors.forename: I J
authors.initials: IJ
authors.lastname: de Castro
authors.forename: M M B
authors.initials: MM
authors.lastname: Dahia
authors.forename: M C V M
authors.initials: MC
authors.lastname: de Azevedo
authors.forename: G A R
authors.initials: GA
authors.lastname: da Silva
authors.forename: R N
authors.initials: RN
authors.lastname: Motta
authors.forename: J
authors.initials: J
authors.lastname: da Cunha Pinto
authors.forename: F R
authors.initials: FR
authors.lastname: de Almeida Ferry
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D060085:Coinfection; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012867:Skin / Q000473:pathology; D013587:Syphilis / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents