Malignant syphilis in an HIV negative patient

Authors

  • María Magdalena Errandonea Dr Manuel Quintela Clinics Hospital, Montevideo, Uruguay
  • Daniela Bermúdez Dr Manuel Quintela Clinics Hospital, Montevideo, Uruguay
  • Andrea Torres Dr Manuel Quintela Clinics Hospital, Montevideo, Uruguay
  • Julio Magliano Dr Manuel Quintela Clinics Hospital, Montevideo, Uruguay

DOI:

https://doi.org/10.47196/da.v31i3.2964

Keywords:

malignant syphilis, necrotic nodules, ulcers

Abstract

Malignant syphilis (MS) is a rare clinical form of secondary syphilis, most often associated with immunosuppression and rarely reported in HIV-negative patients. We describe the case of a patient who presented this clinical variant with necrotic ulcerative nodules located on head, neck, and trunk, without associated immunocompromise. Given its rarity, we aim to provide, with this case, the tools to suspect this form of presentation and thus enable correct diagnosis and treatment.

Author Biographies

María Magdalena Errandonea, Dr Manuel Quintela Clinics Hospital, Montevideo, Uruguay

Dermatology Resident, Chair of Dermatology of Surgical Medicine

Daniela Bermúdez, Dr Manuel Quintela Clinics Hospital, Montevideo, Uruguay

Dermatologist and Surgeon, Assistant at the Dermatology Chair, Chair of Dermatology of Surgical Medicine

Andrea Torres, Dr Manuel Quintela Clinics Hospital, Montevideo, Uruguay

Dermatologist and Surgeon, Assistant at the Dermatology Chair, Chair of Dermatology of Surgical Medicine

Julio Magliano, Dr Manuel Quintela Clinics Hospital, Montevideo, Uruguay

Dermatologist and Surgeon, Mohs Surgeon, Adjunct Professor of the Chair of Dermatology, Chair of Dermatology of Medical and Surgical Medicine

References

I. Cripps DJ, McDonald R. Syphilis maligna praecox. The first patient seen at MGH in 1821. N Engl J Med. 1977;296: 695.

II. Tucker JD, Shah S, Jarell AD, Tsai KY, et ál. Lues maligna in early HIV infection. Case report and review of the literature. Sex Transm Dis. 2009;36:512-514.

III. Wibisono O, Idrus I, Djawad K. Sifilis maligna: revisión sistemática de los casos publicados entre los años 2014-2018. Actas Dermosifiliogr. 2021;112:725-734.

IV. Salazar-Soto M, Wolf-ldárraga JC. Sífilis maligna precoz. Rev Asoc Colomb Dermatol Cir Dematol. 1995;4:62-65.

V. Kumar B, Muralidhar S. Malignant syphilis: a review. AIDS Patient Care and STDs. 1998;12:921-925.

VI. Witkowski JA, Parish LC. The great imitator: malignant syphilis with hepatitis. Clin Dermatol. 2002;20:156-163.

VII. Fisher DA, Chang LW, Tuffanelli DL. Lues maligna. Presentation of a case and a review of the literature. Arch Dermatol. 1969;99:70-73.

VIII. de Unamuno-Bustos B, Sánchez RB, Carazo JLS, de Míquel VA. Malignant syphilis with ocular involvement in an immunocompetent patient. Int J Dermatol. 2014;53:258-260.

IX. Braue J, Hagele T, Yacoub AT, Mannivanan S, et ál. A case of rupioid syphilis masquerading as aggressive cutaneous lymphoma. Mediterr J Hematol Infect Dis. 2015; 7: e2015026.

X. Fernández-Guarino M, de la Mora I, González-García C, Harto-Castaño A, et ál. Sífilis maligna en paciente infectado por el virus de la inmunodeficiencia humana (VIH). Actas Dermosifiliogr. 2006;97:400-403.

Published

2025-12-01

Issue

Section

Clinical Cases