梅毒血清试验呈前带现象的恶性梅毒1例  

A Case of Malignant Syphilis with Syphilis Prezone Phenomenon

作　　者：揭丽云 李强[2] 董海玲[2] 王清玉[2] 刘玮[2] 

机构地区：[1]遵义医学院,贵州遵义563000 [2]中国人民解放军空军总医院皮肤科,北京100142

出　　处：《中国皮肤性病学杂志》2017年第6期647-649,共3页The Chinese Journal of Dermatovenereology

摘　　要：患者男,42岁。全身反复红斑丘疹并溃疡,进行性加重2个月。头面、躯干、四肢及阴茎可见较多红色丘疹、结节、斑肿块、浅表溃疡,部分皮损表面覆有黑色蛎壳样痂皮。右腰部皮损组织病理示:真皮上部大量炎细胞浸润,以淋巴细胞、浆细胞、嗜中性粒细胞为主;免疫组织化学示:CD138(+),Ki67(+<30%),TCR重排阴性。TPPA阳性,RPR 1∶2,1∶4,1∶8,1∶16均阴性,1∶64,1∶128阳性。诊断:梅毒血清试验呈前带现象(syphilis prezone phenomenon)的恶性梅毒。A 42-year-old male presented with erythema papules, and skin ulceration on the entire body for 2 months progressively. Dermatological examination showed a number of red papules, plaques, nodules and superficial ulcers in head and face, arms and legs and the penis, some of the lesions were covered with black rupia like crusts. The histopatologic examination showed dermis with a large number of infiltrating inflammation cells, mainly lymphoeytes, plasma cells and nentrephils. Immunohistoehemistry results demonstrated CD138 were positive and Ki67 （ ＋ 〈 30% ）. TCR gene rearrangement test were negative. Serologic test for syphilis ,TPPA antibody were positive, and RPR test 1 ： 2,1：4,1 ： 8,1 ： 16 were both negative, however, 1 ： 64,1 ： 128 were positive. The diagnosis of secondary syphilis （malignant syphilis with syphilis prezone phenomenon ） was made.

关 键 词：二期梅毒 恶性 前带现象 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]