PMC7178809_01
Clinical images of a 46-year-old female patient. Erythematous and slightly
scaly plaques are seen over the palms (A), soles and medial longitudinal arches
of the feet (B).
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These plantar lesions persist for some time simply as "reddish, pink-grayish or pink-yellowish stains" that are so faint that in some patients "need to be guessed" (Figure 5), reminding us of our patient's initial presentation (Figure 1B).
Two months later there were exuberant pinkish-red scaly lesions on the palms,
with circinate borders in the medial longitudinal arches of the feet.
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Two months later, there were new lesions and the previous ones were larger and tender (Figure 2). In the medial longitudinal arches of the feet, there were large plaques with a thick silvery scale and circinate borders (Figure 2).
Histopathological analyses of skin biopsy samples: A) Hematoxylin and eosin
staining reveals hyperkeratosis, parakeratosis, cellular debris in the corneal
layer, saw tooth acanthosis, vacuolization of the basal cell layer, apoptotic
keratinocytes, as well as an inflammatory infiltrate composed of lymphocytes,
macrophages and plasma cells in the dermo-epidermal junction. There are also
melanophages in the superficial dermis. Original magnification: x 100; B)
Hematoxylin and eosin staining shows an inflammatory infiltrate rich in
plasmocytes (white arrows) and with abundant endothelial edema (black arrows).
Original magnification: x 400; C) Warthin-Starry stain uncovers a
spirochete.
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Histopathological analyses of skin biopsy samples revealed lichenoid dermatitis with perivascular inflammatory infiltrate in the reticular dermis, which was rich in plasmocytes (Figure 3). Spirochetal structures were uncovered by a Warthin-Starry staining (Figure 3C).
Complete remission of the lesions on the palms (A) and soles (B).
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Skin lesions rapidly regressed after the administration of 2.4 million units of intramuscular benzathine penicillin G (Figure 4).
PMC7178809_02
Clinical images of a 46-year-old female patient. Erythematous and slightly
scaly plaques are seen over the palms (A), soles and medial longitudinal arches
of the feet (B).
1678-9946-rimtsp-62-S1678-9946202062021-gf01.jpg
PMC7178809_02_1678-9946-rimtsp-62-S1678-9946202062021-gf01.jpg
f1
These plantar lesions persist for some time simply as "reddish, pink-grayish or pink-yellowish stains" that are so faint that in some patients "need to be guessed" (Figure 5), reminding us of our patient's initial presentation (Figure 1B).
Dermatological wax moullage models of syphilide
psoriasiforme rash from Musee des Moulages,
Hopital Saint-Louis, Paris: A) Syphilide palmaire
psoriasiforme; B) Syphilide plantaire
psoriasiforme. Reproduced with permission ( F.Marin,
P.Simon, Musee des Moulages, Hopital
Saint-Louis, Paris, AP-HP).
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Hospital Museum" (Figure 5). He then explained that "it is impossible not to consider these lesions as psoriasis at a first glance". These plantar lesions persist for some time simply as "reddish, pink-grayish or pink-yellowish stains" that are so faint that in some patients "need to be guessed" (Figure 5), reminding us of our patient's initial presentation (Figure 1B).