文献简介

出版社:JAMA Dermatology

作  者:Ramya Kollipara, MD; Jacqueline A. Guidry, MD; Stephen K. Tyring, MD, PhD

编  号:

关键字:Secondary syphilis

年  份:2015   点击量:198

文献摘要 全文翻译

A 23-year-old white man who has sex with men (MSM) presented with a 1-month history of skin lesions on the palms and soles as well as a 2-week history of lesions in his oropharynx. He reported that a fraction of the lesions had blistered earlier in the course of his illness. The patient also described myalgias and fatigue over the preceding month. He moved to Texas from the northeast a few months prior to his illness. He denied any exposure to sexually transmitted infections or a history of genital lesions. On examination, the patient had erythematous papules on bilateral palms and soles as well as eroded vesicles on the palate (Figure, A and B). Lymphadenopathy was not present. A biopsy specimen of a papule on the left sole was obtained for immunohistochemical staining (Figure, C and D). A serologic antibody test revealed an elevated coxsackievirus titer of 1:16 (reference range, <1:8; >1:32 indicative of infection).

患者,白人男性,23岁,有男-男性接触(MSM)史,手掌和足底出现皮损1月余伴口咽部出现皮损2周。患者自述,病程早期部分皮损处出现水疱,且上月出现肌痛和疲劳感。患病数月前,从东北部移居德克萨斯州。患者否认有任何性传播感染或生殖器皮损史。检查发现,患者手掌双侧和足底出现红色丘疹,腭部出现侵蚀性囊泡(图A和B),排除淋巴系统疾病可能。取左足底丘疹活检标本用于免疫组化染色(图C和D)。血清学抗体检测显示柯萨奇病毒滴度升高至1:16(参考范围,小于1:8;大于 1:32表示感染)。