Rupioid lesions, PLEVA and superposition phenomenon in malignant syphilis: two case reports in HIV- infected patients

Abstract

We present two case reports in HIV-infected patients exhibiting unusual manifestations with rupioid lesions, pityriasis lichenoides et varioliformis acuta (PLEVA) and superposition phenomenon opening differential diagnoses for many other diseases that differs on treatment from syphilis.

Case 1: A 42-year-old male patient, HIV diagnosed at 31, in irregular antiretroviral therapy (ART), reported skin lesions, fever, myalgia, and headache for two months. Physical examination demonstrated submandibular lymphadenomegaly, hepatomegaly, infiltrated papules and erythematous plaques, rupioid lesions, some with ulcers and central necrosis over the face, trunk and body extremities, including palmoplantar regions, oral and genital mucosa (Fig. 1).

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