A 57-year-old man was seen with a 2-week history of progressive enlargement of an asymptomatic genital ulcer associated with bilateral inguinal lymphadenomegaly.
Multiple unprotected heterosexual contacts were reported. The family doctor misdiagnosed primary syphilis with the following laboratory results: negative findings on the Venereal Disease Research Laboratory test, positive findings on the Treponema pallidum particle agglutination assay (titer 1:1280), and IgM negative on the Treponema pallidum particle agglutination assay. The patient was treated with penicillin G for the diagnosis of indeterminate latent syphilis and initially denied authorization for a skin biopsy. After 2 weeks, fast enlargement of the lesion was documented. He underwent skin biopsy, and the histopathologic examination revealed squamous cell carcinoma, and polymerase chain reaction for human papillomavirus 16 was positive.
Written by:
Brunasso AM, Bandelloni R, Massone C. Are you the author?
Department of Environmental Dermatology and Venereology, Medical University of Graz, Graz, Austria.
Reference: Urology. 2012 Jul;80(1):e9-10.
doi: 10.1016/j.urology.2012.04.022
PubMed Abstract
PMID: 22748894
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