A Rare Type of Balanitis
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.29021/spdv.77.4.1107 |
Resumo: | Syphilis is an old disease and a major public health concern, which is re-emerging in the western world. Atypical syphi- litic presentations can be challenging to diagnose. We present a 23-year-old, HIV-positive man who has sex with men who presented with a 2-week history of an asymptomatic lesion on the glans. Previous topical and systemic treatments proved unsuccessful. Physical examination demonstrated a slightly indurated, ill-defined erythematous plaque over most of the glans. Enlarged, non-tender, bilateral inguinal lymph nodes were palpable. Serological tests revealed a fourfold increase in the VDRL titre (1:8, previously 1:2). A diagnosis of syphilitic balanitis of Follmann was made and complete resolution was achieved with an intramuscular single dose of benzathine penicillin 2.4 MU. Syphilitic balanitis of Follmann represents an uncommon manifestation of primary syphilis, with less than 100 cases reported. Untrea- ted, it will resolve spontaneously, but the patient will remain highly infectious and at-risk for long-term morbidity. In an era in which the number of syphilis cases is increasing sharply both in Western Europe and the United States, all physicians should be aware for the typical and atypical early syphilitic manifestations as they represent opportunities of paramount importance for treatment and epide- mic control. |
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A Rare Type of BalanitisUma Forma Rara de BalaniteBalanitisSyphilisSyphilis, CutaneousBalaniteSífilisSífilis CutâneaSyphilis is an old disease and a major public health concern, which is re-emerging in the western world. Atypical syphi- litic presentations can be challenging to diagnose. We present a 23-year-old, HIV-positive man who has sex with men who presented with a 2-week history of an asymptomatic lesion on the glans. Previous topical and systemic treatments proved unsuccessful. Physical examination demonstrated a slightly indurated, ill-defined erythematous plaque over most of the glans. Enlarged, non-tender, bilateral inguinal lymph nodes were palpable. Serological tests revealed a fourfold increase in the VDRL titre (1:8, previously 1:2). A diagnosis of syphilitic balanitis of Follmann was made and complete resolution was achieved with an intramuscular single dose of benzathine penicillin 2.4 MU. Syphilitic balanitis of Follmann represents an uncommon manifestation of primary syphilis, with less than 100 cases reported. Untrea- ted, it will resolve spontaneously, but the patient will remain highly infectious and at-risk for long-term morbidity. In an era in which the number of syphilis cases is increasing sharply both in Western Europe and the United States, all physicians should be aware for the typical and atypical early syphilitic manifestations as they represent opportunities of paramount importance for treatment and epide- mic control.Apesar de ser uma doença antiga, a Sífilis continua uma preocupação muito atual em Saúde Pública e o seu número de casos continua a aumentar. As apresentações atípicas desta infeção podem ser verdadeiros desafios diagnósticos.Relatamos o caso de um homem VIH-positivo de 23 anos de idade, HSH, observadio por uma lesão assintomática na glande com duas semanas de evolução. Vários tratamentos tópicos e sistémicos foram tentados previamente, sem benefício. O exame objetivo demonstrou uma placa eritematosa, mal delimitada, endurecida, de superfície lisa que ocupava a maior parte da glande. Adenome- gálias indolores bilaterais eram palpáveis. Os testes serológicos demonstraram uma subida de 4x o título do VDRL (1:8, previamente 1:2). Foi realizado o diagnóstico de balanite sifilítica de Follmann. A resolução completa da lesão foi conseguida com uma dose única intramuscular de penicilina benzatínica de 2,4 M.U. A balanite sifilítica de Follmann é uma manifestação pouco comum de sífilis primária, havendo menos de 100 casos relatados. Ape- sar das lesões clínicas evoluírem para a resolução espontânea mesmo sem tratamento adequado, o doente permanecerá altamente infecioso e em risco de morbilidade futura. Numa era em que o número de casos de sífilis têm aumentado rapidamente na Europa Ocidental e Estados Unidos, recomenda-se que se conheçam as manifestações clássicas e atípicas de sífilis precoce, já que estas representam oportunidades únicas para tratamento e prevenção de transmissão futura de doença pelo individuo infetado.Sociedade Portuguesa de Dermatologia e Venereologia2020-01-11T00:00:00Zjournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.29021/spdv.77.4.1107oai:ojs.revista.spdv.com.pt:article/1107Journal of the Portuguese Society of Dermatology and Venereology; Vol 77 No 4 (2019): October - December; 349-351Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 77 n. 4 (2019): Outubro - Dezembro; 349-3512182-24092182-2395reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://revista.spdv.com.pt/index.php/spdv/article/view/1107https://doi.org/10.29021/spdv.77.4.1107https://revista.spdv.com.pt/index.php/spdv/article/view/1107/806Duarte, BrunoRodrigues, AnaFernandes, Cândidainfo:eu-repo/semantics/openAccess2022-10-06T12:35:12Zoai:ojs.revista.spdv.com.pt:article/1107Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:11:10.864601Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
A Rare Type of Balanitis Uma Forma Rara de Balanite |
title |
A Rare Type of Balanitis |
spellingShingle |
A Rare Type of Balanitis Duarte, Bruno Balanitis Syphilis Syphilis, Cutaneous Balanite Sífilis Sífilis Cutânea |
title_short |
A Rare Type of Balanitis |
title_full |
A Rare Type of Balanitis |
title_fullStr |
A Rare Type of Balanitis |
title_full_unstemmed |
A Rare Type of Balanitis |
title_sort |
A Rare Type of Balanitis |
author |
Duarte, Bruno |
author_facet |
Duarte, Bruno Rodrigues, Ana Fernandes, Cândida |
author_role |
author |
author2 |
Rodrigues, Ana Fernandes, Cândida |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Duarte, Bruno Rodrigues, Ana Fernandes, Cândida |
dc.subject.por.fl_str_mv |
Balanitis Syphilis Syphilis, Cutaneous Balanite Sífilis Sífilis Cutânea |
topic |
Balanitis Syphilis Syphilis, Cutaneous Balanite Sífilis Sífilis Cutânea |
description |
Syphilis is an old disease and a major public health concern, which is re-emerging in the western world. Atypical syphi- litic presentations can be challenging to diagnose. We present a 23-year-old, HIV-positive man who has sex with men who presented with a 2-week history of an asymptomatic lesion on the glans. Previous topical and systemic treatments proved unsuccessful. Physical examination demonstrated a slightly indurated, ill-defined erythematous plaque over most of the glans. Enlarged, non-tender, bilateral inguinal lymph nodes were palpable. Serological tests revealed a fourfold increase in the VDRL titre (1:8, previously 1:2). A diagnosis of syphilitic balanitis of Follmann was made and complete resolution was achieved with an intramuscular single dose of benzathine penicillin 2.4 MU. Syphilitic balanitis of Follmann represents an uncommon manifestation of primary syphilis, with less than 100 cases reported. Untrea- ted, it will resolve spontaneously, but the patient will remain highly infectious and at-risk for long-term morbidity. In an era in which the number of syphilis cases is increasing sharply both in Western Europe and the United States, all physicians should be aware for the typical and atypical early syphilitic manifestations as they represent opportunities of paramount importance for treatment and epide- mic control. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-01-11T00:00:00Z |
dc.type.driver.fl_str_mv |
journal article info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.29021/spdv.77.4.1107 oai:ojs.revista.spdv.com.pt:article/1107 |
url |
https://doi.org/10.29021/spdv.77.4.1107 |
identifier_str_mv |
oai:ojs.revista.spdv.com.pt:article/1107 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://revista.spdv.com.pt/index.php/spdv/article/view/1107 https://doi.org/10.29021/spdv.77.4.1107 https://revista.spdv.com.pt/index.php/spdv/article/view/1107/806 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Dermatologia e Venereologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Dermatologia e Venereologia |
dc.source.none.fl_str_mv |
Journal of the Portuguese Society of Dermatology and Venereology; Vol 77 No 4 (2019): October - December; 349-351 Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 77 n. 4 (2019): Outubro - Dezembro; 349-351 2182-2409 2182-2395 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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