少见的皮肤附属器梅毒2例报告

Two rare cases of syphilis associated with diseases of skin appendages

本文报告少见的皮肤附属器梅毒2例。例1为梅毒性脱发。女性,38岁,以脱发为唯一表现,不伴有梅毒的其它症状和体征。患者头顶部、颞部毛发明显稀疏,有点状或小片状不规则脱发区,抗梅治疗结束时脱发得到控制,2个月后头发完全长出。梅毒性脱发单独出现时,注意勿漏诊。例2为梅毒性甲病。女性,20岁,二期梅毒患者,二期梅毒疹同时伴有部分手指甲床破损,甲沟轻度红斑,KOH真菌镜检阴性。抗梅治疗结束3个月后病甲恢复正常。

Two cases of syphilis associated with skin appendages diseases are reported. Cases 1： A 38 year- old female patient of syphilitic alopecia. Hair loss was the only finding of her syphilis. Dots or small patches of alopecia were irregularly distributed on temporal sides, occipital parts and on top of her scalp. The hair loss stopped right after the finish of 3 - week treatment with benzathine penicillin G, and fully recovered 2 months after the treatment. Hair loss can provide clues to diagnosis especially when presented as the only skin manifestation of syphilis. Case 2 ： Syphilitic nail disease. A 20 year - old female patient of secondary syphilis with macular syphilitic skin rash developed simultaneously nail abnormalities on some of her fingernails. Some nails showed superficial lyses of nail plates and mild erythema and scaling on the nail grooves （paronychia）. KOH test for fungus gave negative result. The nails get completely recovered 3 months after anti - treponemal treatment. Nail changes associated with syphilis is uncommon.