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KMID : 0351220000320020164
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Korean Journal of Infectious Diseases
2000 Volume.32 No. 2 p.164 ~ p.166
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Extragenital Primary Syphilis Acquired by Scratching with the Fingernails
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최강원/1Joo Yong Han
1Myoung Don Oh/1Sun Hee Lee/1Nam Joong Kim/1Kang Won Choe/2Chul Woo Kim
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Abstract
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A 46-year-old woman was admitted with an ulcerative lesion on the posterior neck. Four months before admission, the patient took part in a faith healing ritual, which the pastor performed with his fingernails causing wounds. This abnormal method of healing caused repeated injury to the patient in the posterior neck area. Treatment with cefazolin was begun, but the lesion did not improve. Biopsy of the skin lesion and cervical lymph nodes was performed. Microscopical examination revealed findings highly suggestive of syphilis. Serological tests for syphilis were positive and a computed tomographic (CT) scan of the neck showed enlargement of regional lymph nodes and tonsils. A single dose of penicillin G 2.4 million units was given intramuscularly. Two weeks later, the wound had healed. Eight weeks after treatment, the Venereal Disease Research Laboratory titer had decreased and a CT scan of the neck showed a decrease in the size of the lymph nodes. We reasoned that syphilis was non- sexually transmitted, and that the healing ritual was the cause. Our case suggests that skin trauma by scratching with the fingernails may cause an accidental direct inoculation of Treponema pallidum, resulting in extragenital primary syphilis.
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KEYWORD
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Syphilis, Skin, Scratching,
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