| Autor: |
Cantisani C; Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, 'Sapienza Medical School' University of Rome, 00185 Rome, Italy., Rega F; Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, 'Sapienza Medical School' University of Rome, 00185 Rome, Italy., Ambrosio L; Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, 'Sapienza Medical School' University of Rome, 00185 Rome, Italy., Grieco T; Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, 'Sapienza Medical School' University of Rome, 00185 Rome, Italy., Kiss N; Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary., Meznerics FA; Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary., Bánvölgyi A; Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary., Vespasiani G; Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, 'Sapienza Medical School' University of Rome, 00185 Rome, Italy., Arienzo F; Department of Radiological, Oncological and Pathological Sciences, 'Sapienza Medical School' University of Rome, 00161 Rome, Italy., Rossi G; Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, 'Sapienza Medical School' University of Rome, 00185 Rome, Italy., Soda G; Department of Radiological, Oncological and Pathological Sciences, 'Sapienza Medical School' University of Rome, 00161 Rome, Italy., Pellacani G; Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, 'Sapienza Medical School' University of Rome, 00185 Rome, Italy. |
| Abstrakt: |
Syphilis is characterized by a wide range of variable clinical symptoms; therefore, it is often referred to as "The Great Imitator". Here, we report the case of a 69-year-old hepatitis-C-positive MSM patient, who was admitted to our clinic due to a solitary firm painless erythematous maculopapular lesion with a central crater-like crust on the upper right thigh that occurred two months prior. The dermoscopy showed an erythematous, copper-colored, oval lesion with diffuse monomorphic dotted and glomerular vessels, central crust, and circular scaling (Biett's sign). The histological findings ruled out neoplasia and described a plasma cell infiltrate and endothelial swelling. Finally, the combination of the dermoscopic image, histological findings and the additionally acquired knowledge about the sexual history of the patient at the second visit led to the diagnosis, which was then confirmed with serological tests. Dermoscopy may become a supportive tool to facilitate the recognition of secondary syphilis; however, the reporting of these atypical cases is crucial to highlight the many faces of the disease so that clinicians consider syphilis as part of the differential diagnosis of non-specific lesions. |
