Sífilis secundaria en vulva: una presentación inusual
Syphilis is an infection caused by the bacterium Treponema pallidum, transmitted through sexual contact, congenital transmission, and perinatal transmission. It affects people between 15 and 49 years of age and is curable. Known as the " the great simulator” due to the diversity of clinical pre...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2025
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/50388 |
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I10-R327-article-50388 |
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| institution |
Universidad Nacional de Córdoba |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
cutaneous syphilis condyloma treponema pallidum sífilis cutánea condiloma treponema pallidum |
| spellingShingle |
cutaneous syphilis condyloma treponema pallidum sífilis cutánea condiloma treponema pallidum Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M Sífilis secundaria en vulva: una presentación inusual |
| topic_facet |
cutaneous syphilis condyloma treponema pallidum sífilis cutánea condiloma treponema pallidum |
| author |
Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M |
| author_facet |
Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M |
| author_sort |
Castellanos Posse , L |
| title |
Sífilis secundaria en vulva: una presentación inusual |
| title_short |
Sífilis secundaria en vulva: una presentación inusual |
| title_full |
Sífilis secundaria en vulva: una presentación inusual |
| title_fullStr |
Sífilis secundaria en vulva: una presentación inusual |
| title_full_unstemmed |
Sífilis secundaria en vulva: una presentación inusual |
| title_sort |
sífilis secundaria en vulva: una presentación inusual |
| description |
Syphilis is an infection caused by the bacterium Treponema pallidum, transmitted through sexual contact, congenital transmission, and perinatal transmission. It affects people between 15 and 49 years of age and is curable. Known as the " the great simulator” due to the diversity of clinical presentations, the recent increase in cases, and the lack of timely diagnosis and treatment, it alerts us to rare manifestations, such as secondary syphilis (SS). This entity presents: a maculopapular skin rash primarily on the trunk (roseola) and/or the palms and soles, pinkish; flat condylomas in the anogenital area or medial thighs; and mucous plaques on the tongue, lips, and mouth. Differential diagnoses include condylomata acuminata (CA), fibroepithelial polyps (FP), squamous cell cancer, among others. Histopathologically, they present a lymphoplasmacytic infiltrate with or without obliterative endarteritis. The combination of psoriasiform, lichenoid, and spongiotic patterns and the presence of numerous plasma cells is indicative of SS. This case report is notable for the unusual clinical manifestation of SS on the vulva, with no other mucocutaneous involvement.
CASE PRESENTATION: A 50-year-old female patient presented with multiple condylomatous lesions on the vulva and anus, with a 4-month of evolution and no other condition. Based on the suspected diagnosis of CA, the Gynecology and Dermatology Department decided to carry out a biopsy. Macroscopically, an elevated, light-brown lesion measuring 0.8 x 0.6 cm was observed. Microscopically, the epidermis showed hyperkeratosis and accumulations of polymorphonuclear neutrophils on the surface, and pseudoepitheliomatous hyperplasia with moderate spongiosis. The dermis revealed a moderate to intense lymphoplasmacytic inflammatory infiltrate with polymorphonuclear neutrophils and marked transepithelial migration. A diagnosis of a vulvar lesion with a neutrophilic spongiotic pattern and predominantly plasmacytic inflammation was reached. Based on the morphological characteristics, the lesion likely suggested SS, but AC was ruled out. A VDRL was performed, confirming the diagnosis of SS. Treatment with intramuscular penicillin was indicated, and the lesion resolved completely.
We describe an unusual clinical manifestation of SS in the vulva, which is clinically relevant to considering differential diagnoses such as AC and PF. We emphasize the value of the biopsy, which guided the diagnosis, and later confirmed by serology, ruling out other pathologies, allowing for early diagnosis, timely treatment, and resolution, highlighting the multidisciplinary approach. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2025 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/50388 |
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I10-R327-article-503882025-11-13T12:04:31Z Sífilis secundaria en vulva: una presentación inusual Secondary vulvar syphilis: an unusual presentation Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M Castellanos Posse , L El Ganame, J Suárez Ghibaudo, H Moyano Crespo, G Manrique, V Matsuzaki, M Giménez, N Herrero, M cutaneous syphilis condyloma treponema pallidum sífilis cutánea condiloma treponema pallidum Syphilis is an infection caused by the bacterium Treponema pallidum, transmitted through sexual contact, congenital transmission, and perinatal transmission. It affects people between 15 and 49 years of age and is curable. Known as the " the great simulator” due to the diversity of clinical presentations, the recent increase in cases, and the lack of timely diagnosis and treatment, it alerts us to rare manifestations, such as secondary syphilis (SS). This entity presents: a maculopapular skin rash primarily on the trunk (roseola) and/or the palms and soles, pinkish; flat condylomas in the anogenital area or medial thighs; and mucous plaques on the tongue, lips, and mouth. Differential diagnoses include condylomata acuminata (CA), fibroepithelial polyps (FP), squamous cell cancer, among others. Histopathologically, they present a lymphoplasmacytic infiltrate with or without obliterative endarteritis. The combination of psoriasiform, lichenoid, and spongiotic patterns and the presence of numerous plasma cells is indicative of SS. This case report is notable for the unusual clinical manifestation of SS on the vulva, with no other mucocutaneous involvement. CASE PRESENTATION: A 50-year-old female patient presented with multiple condylomatous lesions on the vulva and anus, with a 4-month of evolution and no other condition. Based on the suspected diagnosis of CA, the Gynecology and Dermatology Department decided to carry out a biopsy. Macroscopically, an elevated, light-brown lesion measuring 0.8 x 0.6 cm was observed. Microscopically, the epidermis showed hyperkeratosis and accumulations of polymorphonuclear neutrophils on the surface, and pseudoepitheliomatous hyperplasia with moderate spongiosis. The dermis revealed a moderate to intense lymphoplasmacytic inflammatory infiltrate with polymorphonuclear neutrophils and marked transepithelial migration. A diagnosis of a vulvar lesion with a neutrophilic spongiotic pattern and predominantly plasmacytic inflammation was reached. Based on the morphological characteristics, the lesion likely suggested SS, but AC was ruled out. A VDRL was performed, confirming the diagnosis of SS. Treatment with intramuscular penicillin was indicated, and the lesion resolved completely. We describe an unusual clinical manifestation of SS in the vulva, which is clinically relevant to considering differential diagnoses such as AC and PF. We emphasize the value of the biopsy, which guided the diagnosis, and later confirmed by serology, ruling out other pathologies, allowing for early diagnosis, timely treatment, and resolution, highlighting the multidisciplinary approach. La sífilis es una infección producida por la bacteria Treponema pallidum, transmitida por contacto sexual, transmisión congénita y perinatal. Afecta a personas entre 15 a 49 años y es curable. Conocida como la gran simuladora por la diversidad de presentaciones clínicas, el incremento de casos recientemente, la falta de diagnóstico y tratamiento oportuno, nos alerta sobre manifestaciones infrecuentes, como la sífilis secundaria (SS). Esta presenta: erupción cutánea maculopapular principalmente en tronco (roséola) y/o en las palmas y las plantas, rosadas; condilomas planos, en la zona anogenital o parte medial de los muslos y placas mucosas en la lengua, labios y boca. Los diagnósticos diferenciales incluyen, condilomas acuminados (CA), pólipos fibroepiteliales (PF), cáncer de células escamosas, entre otros. Histopatológicamente presentan infiltrado linfoplasmocitario con o sin endarteritis obliterante, siendo la combinación del patrón psoriasiforme, liquenoide, espongiótico y la presencia de numerosos plasmocitos, orientadores de SS. La comunicación del caso, se destaca por la manifestación clínica inusual de SS en vulva, sin otra afección mucocutánea. PRESENTACIÓN DE CASO: paciente femenina de 50 años, consultó por múltiples lesiones condilomatosas en vulva y ano, de 4 meses de evolución, sin otra afección. Ante la sospecha diagnóstica del servicio de ginecología y dermatología de CA se decide tomar biopsia. Macroscópicamente se observó lesión sobreelevada pardo clara que mide 0.8 x 0.6 cm. Microscópicamente mostró epidermis con hiperqueratosis y acúmulos de polimorfonucleares neutrófilos en superficie e hiperplasia pseudoepiteliomatosa con moderada espongiosis. En dermis se evidenció moderado a intenso infiltrado inflamatorio linfoplasmocitario con polimorfonucleares neutrófilos y marcada migración transepitelial. Se llega al diagnóstico de lesión de vulva con patrón espongiótico neutrofílico e inflamación predominantemente plasmocítico, sugiriendo por las características morfológicas probable SS, descartando CA. Se solicitó VDRL confirmando el diagnóstico de SS. Se indica tratamiento con penicilina intramuscular, observándose resolución completa de la lesión. Damos a conocer una manifestación clínica inusual de SS en vulva, alertando clínicamente a considerar diagnósticos diferenciales como CA y PF principalmente. Destacando el valor de la biopsia, que orientó al diagnóstico, confirmado por serología, descartando otras patologías, permitiendo un diagnóstico precoz, tratamiento oportuno y resolución, resaltando el enfoque multidisciplinario. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2025-11-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/50388 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 82 (2025): Suplemento JIC XXVI Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 82 (2025): Suplemento JIC XXVI Revista da Faculdade de Ciências Médicas de Córdoba; v. 82 (2025): Suplemento JIC XXVI 1853-0605 0014-6722 spa https://revistas.unc.edu.ar/index.php/med/article/view/50388/50526 Derechos de autor 2025 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |