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Psoriasiform Eruption and Pharyngitis—Diagnosis
Arch Dermatol. 2008;144(2):255-260.
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Diagnosis: Secondary syphilis.
MICROSCOPIC AND LABORATORY FINDINGS AND CLINICAL COURSE
Histopathologic examination showed hyperkeratosis and psoriasiform hyperplasia of the epidermis and a dense plasma cell–rich infiltrate in the dermis. A Treponema pallidum–specific immunoperoxidase stain was intensely positive within the epidermis and dermis. Serologic findings were positive for the VDRL test and the T pallidum hemoagglutination assay (TPHA), with a dilution of 1:32 and 1:5120, respectively; findings were also positive for the treponemal antibody-absorption test. Neurologic evaluation and cerebrospinal fluid tests ruled out neurosyphilis. Total body tomographic scans excluded extracutaneous involvement.
The patient denied a history of primary chancre and admitted to having interrupted his highly active antiretroviral therapy (HAART) several months before the appearance of the skin lesions. Skin and nail cultures were negative for fungi.
Treatment was begun with intramuscular penicillin G benzathine, 2 400 000 IU weekly for 3 consecutive weeks, and with topical 40% urea ointment to the palms and soles. Physical examination also revealed a discrete transparent . . . [Full Text of this Article] DISCUSSION
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Arch Dermatol. 2008;144(2):255-260.
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