外阴及肛周巨大扁平湿疣一例

A case of giant condyloma latum in vulvar and perianal areas

扁平湿疣是二期梅毒的典型皮损,常出现于最初发生硬下疳的邻近部位,研究发现扁平湿疣的梅毒螺旋体载量明显高于其他的二期梅毒疹。该文报告1例表现为外阴、肛周巨大扁平湿疣的二期梅毒。17岁女性患者因“外阴、肛周斑块2月余”就诊,专科查体:外阴、肛周可见红色湿润斑块,表面呈分叶状、疣状,融合成片,大小为12 cm×3 cm。实验室检查梅毒非特异性血清试验滴度为1∶64,梅毒特异性抗体检测189.000 COI,诊断为二期梅毒。予苄星青霉素驱梅治疗3周后,皮疹消退。该例提示皮疹生长迅速、体积巨大,临床少见,易误诊为巨大尖锐湿疣。

Condyloma latum is a typical lesion of secondary syphilis,which usually appears in the vicinity of the initial chancre.It is found that treponema pallidum load in condyloma latum is significantly higher than that in other secondary syphilis.We report a case of mesosyphilis presented as giant flat condyloma latum in vulvar and perianal areas.A 17-year female patient came to our clinic,complaining of plaques in vulvar and perianal areas more than 2 months.Physical examination showed giant red moist plaques in vulvar and perianal areas.The titer of non-specific antibody for syphilis was 1∶64 and the specific antibody test for syphilis showed a value of 189.000 COI.The patient was diagnosed as secondary syphilis and treate with benzathine penicillin.The rash subsided after 3-week treatment.This case of condyloma latum with giant red plaques was easily misdiagnosed as condyloma acuminatum.