Concluded Case

MENTION Dx - conclusion

QUIZ:- A previously healthy 32-yo man presented w/ a 3-mo hx of multiple mildly pruritic lesions on his head, chest, back, left forearm, and legs. No fever/malaise/HA/arthralgia. Social hx: unprotected sexual intercourse w/ several partners. Exam: multiple annular concentric plaques w/ slightly raised scaly borders. Lab tests confirmed the dx. What is it? conclusion tomorrow..

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Concluded answer

CONCLUSION:- The lesions are typical of annular secondary syphilis (annular, arcuate, or gyrate patterns w/ delicate, slightly raised, infiltrated, or scaling ridges), and a positive rapid plasma reagin test confirmed it. During the course of untreated secondary syphilis, annular lesions may appear and disappear; when they reappear, the lesions are usually larger, darker, and more discrete. A generalized nonpruritic maculopapular rash is more common than an annular rash in secondary syphilis. Pt was treated w/ IM penicillin G benzathine, and the lesions resolved after 3wk, w/ only slight hyperpigmentation visible.

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CONCLUSION:- The lesions are typical of annular secondary syphilis (annular, arcuate, or gyrate patterns w/ delicate, slightly raised, infiltrated, or scaling ridges), and a positive rapid plasma reagin test confirmed it. During the course of untreated secondary syphilis, annular lesions may appear and disappear; when they reappear, the lesions are usually larger, darker, and more discrete. A generalized nonpruritic maculopapular rash is more common than an annular rash in secondary syphilis. Pt was treated w/ IM penicillin G benzathine, and the lesions resolved after 3wk, w/ only slight hyperpigmentation visible.

Annular concentric pigmented plaque with scaling It is characteristic of secondary Syphilis VDRL is screening test for Syphilis And it is to be followed by Treponema pallidum hemagglutination test - which is diagnostic test for Syphilis All patients with Syphilis need to be treated for HIV , because of close association between the two Syphilis need to be treated with injectable Benzathin penicillin - but It is not easily available Second line drug for Syphilis is C. Doxycycline 100 mg twice a day for 30 days To see if Syphilis is cured or not, TPHA test need to be repeated at 6 month interval At this interval there should be for fold drop in TPHA titre, which will indicate complete cure and eradication of disease If such a drop is not found then it is considered as failure to cure - in such circumstances treatment of Syphilis is too be repeated - This time with T. Azithromycin Once VDRL test is positive -- it remains positive for long term, therefore it can not be used for confirming cure from disease

Its one of the skin related HIV condion ...among.. ** Molluscum contagiosum. ... **Herpes viruses. ... **Kaposi sarcoma. ... **Oral hairy leukoplakia. .. **.Thrush. ... **Photodermatitis. .. **.Prurigo nodularis.

IT'S A..CASE OF.. SKIN LESIONS.. ? SYPHILITIC SKIN LESIONS.. ? HIV..SKIN LESIONS.. ? MYCOSIS FUNGOIDES

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* KOPOSI,S SARCOMA ** SECONDARY SYPHILIC IN H I V INFECTED PATIENT

Thanks Dr kute Ankush
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Skin lesions Kaposi sarcoma Syphilis HIV inf. Rashes

Its a case of syphilis.VDRl screening will be required.It needs to be treated with injectable Benzathin penicillin.

SUGGESTIVE OF H HV. - 8. INFECTION DD SECONDARY SYPHILITIC IN. H. I. V. PATIENT. ????

Kaposi's sarcoma / secondary Syphilis ask for Viral MARKA VDRL

H I v infection rashes

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