多形性皮疹伴秃发为特征的二期梅毒1例

A Case of Secondary Syphilis Characterized by Pleomorphic Rash and Alopecia Areata

患者女,31岁。全身反复红斑鳞屑进行性加重1月余伴脱发。皮肤专科检查:头部毛发稀疏,期间散在多处脱发区,边界清楚,基底颜色正常,表面光滑无鳞屑,整个头皮外观呈虫蚀状。腰部散在灰白色斑片伴鳞屑,双手掌椭圆形及圆形的斑片伴鳞屑、铜红色斑疹,逐渐向前臂蔓延。手腕部有红斑、皲裂、血痂,双足散在的红斑鳞屑,足底铜色斑块。梅毒螺旋体明胶凝集试验(+),梅毒螺旋体抗体:19. 88↑,快速血浆反应素试验:1∶64,HIV抗体(-)。诊断:二期梅毒。

A 31-year-old female presented progressive systemic and repeated erythema scale that aggravated for more than one month with hair loss.Skin examination showed sparse hair,scattered alopecia with clear boundary and normal color.The surface was smooth without scales.Spots scattered in the waist with scales.Oval and round plaques on palms with scales and copper red spots,which gradually spread to the forearm.The wrist presented red spots,rhagadia,blood scab,while erythema scale scattered on feet,copper spots on sole.Treponema pallidum gelatin agglutination test(+),treponema pallidum antibody(19.88↑),rapid plasma reactive hormone test(RPR)1:64,HIV antibody(-).Diagnosis;secondary syphilis.