易误诊的二期梅毒一例

Misdiagnosis of secondary syphilis:a case report

患者,男,34岁。左鼻孔、阴囊起无痛性丘疹、结节2个月。皮肤科检查:左鼻孔见一枚黄豆大丘疹,阴囊根部可见一蚕豆大结节。临床诊断为肿瘤,予手术切除。术前血液常规检查示:TPPA≥1∶2560;TRUST:1∶4;TPAB-ELISA:阳性。阴囊结节活检病理示表皮突增生延长,表皮内可见角化物,真皮浅层可见包含大量浆细胞的炎细胞浸润巢,诊断为二期梅毒。

A 34-year-old man presented with bean-sized papules on his nostril and broad bean-size nodule on his scrotum for two months.The primary dignosis was tumor and the patient was planned to treat by surgery.The preoperative blood test showed TPPA≥1∶2560,TRUST:1∶4 and positive of TPAB-ELISA.The biopsy of his scrotal nodules revealed that epidermal process hyperplasia,keratinous material in the epidermis,a massive infiltration of plasma cells in the the upper dermis.The diagnosis of secondary syphilis was made.