1/15. Superimposed primary chancre in a patient with Adamantiades-Behcet's disease. Adamantiades-Behcet's disease was diagnosed in a 42 year old Turkish patient with recurrent oral aphthae, genital ulcerations, papules, and sterile pustules, histologically presenting as cutaneous vasculitis, and intermittent arthritis with joint effusion particularly of the knees. Six months after initial improvement under treatment with colchicine 2 mg/day, a solitary genital ulcer with enlarged inguinal lymph nodes appeared and persisted for 7 weeks despite the continuation of colchicine treatment and the introduction of clindamycin 2 mg/day intravenously. The unusual persistence of the ulcer and the failure of clindamycin therapy led to further differential diagnostic considerations and the identification of primary syphilis. The genital lesion healed 4 weeks after initiation of treatment with tetracycline 2 mg/day by mouth for 15 days. ( info) |
2/15. Primary syphilis remains a cause of oral ulceration. After many years the incidence of infective syphilis (infection with treponema pallidum) is increasing in the United Kingdom. This may reflect changes in sexual attitudes and behaviour, altering trends in hiv disease, and increased foreign travel. Oral disease as a consequence of primary syphilis is rare. The present report details two patients presenting to an oral medicine clinic in london, within a 6-month period in 1999, with oral ulceration as their only clinical manifestation of undiagnosed primary syphilis. The oral aspects of early syphilis and the need for dentists to be aware of changing epidemiological trends in relevant infectious diseases are highlighted. ( info) |
3/15. Syphilitic balanitis of Follmann developing after the appearance of the primary chancre. A case report. A case of primary syphilitic chancre of the coronal sulcus with subsequent development of syphilitic balanitis of Follmann is described. The histopathological picture and preponderantly intraepidermal localization of T. pallidum in the lesions is discussed. ( info) |
4/15. Relapse of early syphilis on first line treatment. We describe a case of a heterosexual hiv-negative man treated for primary syphilis with oral doxycycline in accordance with Clinical Effectiveness Group guidelines for treatment of early syphilis. Following an initial adequate response, he developed secondary syphilis three months later. We discuss the most likely cause of this relapse and the significance of such cases in the context of an outbreak of syphilis. ( info) |
| Three representative cases of oral primary syphilis are presented. We wish to highlight the resurgence of this disease, which has occurred recently in the western world, particularly in europe and the united states of America. Since the initial presentation may be oral, it is important to include syphilis in the differential diagnosis of patients presenting to oral diagnostic clinics with atypical oral ulceration. Recent developments in the serological diagnostic tests and treatment are reviewed. early diagnosis and treatment has significant implications, not only for the patient, but also for previous and future transmission to contacts. Early syphilis is a highly infectious disease in which the lesions heal spontaneously, despite inappropriate treatment which may appear curative, and yet the patient remains infectious. It is therefore important that clinicians maintain a high clinical index of suspicion and crucial that an accurate diagnosis be made at presentation. ( info) |
6/15. Primary tuberculous chancre in a renal transplant patient. A case of primary tuberculous chancre of the vulva is reported. Although a tuberculous infection in an immunocompromised patient is not uncommon, this is the first report of a primary tuberculous infection on the external genitalia in such a patient. The source of infection in this patient could not be determined. ( info) |
7/15. chancre redux or reinfection? A case report in an hiv-positive man. An hiv-positive heterosexual man presented with a recurrent penile chancre, 20 months after treatment with intramuscular procaine benzyl penicillin. Was this a rare case of chancre redux (monorecidive) or re-infection? ( info) |
8/15. Primary syphilis of the eyelid: case report. Primary syphilis of the palpebral conjunctiva of the lower eyelid is reported because it is rare, which makes its diagnosis difficult but important. ( info) |
9/15. Unusual location of syphilitic chancre: case report. A case of secondary syphilis in which the patients still had the primary chancre is reported. The unusual clinical feature was the location of the syphilitic on the arm. ( info) |
10/15. Extragenital syphilitic chancres. Two patients with extragenital chancres are presented to emphasize unusual expressions of primary syphilis. The clinical presentations and differential diagnosis of extragenital chancres are discussed. ( info) |