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Vol. 114. Núm. 5.
Páginas 447 (mayo 2023)
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Vol. 114. Núm. 5.
Páginas 447 (mayo 2023)
Imaging in Dermatology
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Condylomata Lata and Papular Rash of Secondary Syphilis
Condiloma lata y erupción papular de sífilis secundaria
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A. Herzum
Autor para correspondencia
astridherzum@yahoo.it

Corresponding author.
, M. Burlando, C. Micalizzi, A. Parodi
DISSAL, Section of Dermatology, University of Genoa, Ospedale Policlinico San Martino IRCCS, Genova, Italy
Contenido relaccionado
Actas Dermosifiliogr. 2023;114:T44710.1016/j.ad.2023.04.006
A. Herzum, M. Burlando, C. Micalizzi, A. Parodi
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A 41-year-old-man presented with a 2-month history of painful perianal lesions and various maculo-papular lesions that occurred simultaneously on his lower limbs.

He reported generalized fatigue and previous unprotected homosexual intercourse.

Physical examination evidenced moist-to-macerated, flat-topped, tumor-like nodules around the anus, surrounded by erythemato-squamous annular patches and scattered papules (Fig. 1A).

Figure 1
(0,08MB).

On the legs and soles, coppery-shaded erythemato-squamous, nummular plaques and papules were noted, some of which with a collarette of scale (Fig. 1B).

The clinical presentation of these lesion was highly suggestive for condylomata lata (CL) and for secondary syphilis papular squamous rash.

Positive TPHA and VDRL confirmed the clinical suspect of secondary syphilis. The patient was treated with long-acting Benzathine G-penicillin (2.4MU intramuscularly).

Secondary syphilis is polymorphic, causing initial maculo-papular rush, followed by persistent erythemato-papulo-squamous lesions, as on our patient's legs, soles and perineum.1 Also, 6–23% present CL: vegetating, flat-topped, infectious lesions, painful when macerated by friction, which also perpetuates dissemination.

Dermatologists play a key role in identifying and treating syphilis. It is therefore of great importance to increase the clinicians’ ability to diagnose syphilis precociously, to prevent complications, destructive consequences and disease transmission.2

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