Syphilitic Palmoplantar Keratoderma and Ocular Disease: A Rare Combination in an HIV-Positive Patient
This article has been peer reviewed and approved by Michael Fisher, MD, Professor of Medicine, Albert Einstein College of Medicine. Review date: November 2009.
Drs. Sciacca Kirby and Mahoney and Mr. Goreshi report no conflict of interest. The authors report no discussion of off-label use. Dr. Fisher reports no conflict of interest. The staff of CCME of Albert Einstein College of Medicine and Cutis® have no conflicts of interest with commercial interest related directly or indirectly to this educational activity. Dr. Sciacca Kirby is Assistant Professor, Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania. Mr. Goreshi is a medical student, University of Pennsylvania School of Medicine, Philadelphia. Dr. Mahoney is a resident, Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania.
Joslyn Sciacca Kirby, MD; Renato Goreshi, BS; Nicholas Mahoney, MD
Approximately 349 million individuals worldwide are actively infected with syphilis. The incidence of syphilis in North America and Europe is low but has been rising in recent years. The rate of concomitant infection with human immunodeficiency virus (HIV) and syphilis also has been increasing. Concomitant infection with HIV can cause syphilis to have atypical characteristics. These atypical findings can involve the skin as well as organs that rarely are affected in HIV-negative individuals such as the eyes. We present a case of syphilis causing palmoplantar keratoderma and ocular disease in a patient with HIV infection, and discuss the differences in diagnosis and treatment of patients with both diseases.