以环形红斑和水疱为主要表现的二期梅毒1例

Secondary Syphilis Manifested as Annular Erythema and Vesicles: a Case Report

患者男,73岁。躯干及四肢反复多发环形红斑丘疹及水疱伴瘙痒5个月,曾按"皮肤过敏"治疗,效果不佳。皮肤科情况:躯干及四肢见环形红斑、水疱及浸润性暗红斑块。实验室检查:梅毒螺旋体明胶凝集试验(TPPA):1∶1 280(+),快速血浆反应素试验(RPR):1∶32(+),HIV抗体(-)。诊断:二期梅毒。予苄星青霉素240万U分两侧臀部肌肉注射,1次/周,连用3周后皮损基本消退。目前仍在随访中。

A 73-year-old man presented with itchy, annular erythema, papules and vesicles on the trunk and limbs for five months. He was initially treated as skin allergy and did not get any improvement. There were annular erythema, vesicles and infiltrative dark red plaques found. Serologic study showed positivity for Treponema pallidum particle agglutination assay （TPPA） 1：1 280（ ＋ ）, rapid plasma reagin test （RPR） 1：32 （ ＋ ）, with undetectable anti-HIV antibody. He was diagnosed as secondary syphilis. Three doses of 2. 4 million units of benzathine penicillin were intramuscularly administered once a week. Most of rashes disappeared after 3 weeks. The patient was followed up periodically.