Herpes simplex virus ( HSV ) (cold sores) – persisting and extensive.Herpes zoster virus (HZV) (shingles) involving multiple nerve pathways.Bacterial skin sores (folliculitis, impetigo).Fungal infection of the nails (onychomycosis).An existing rash may worsen with Jarisch-Herxheimer reaction (fever, headache, lymphadenopathy and rash) associated with penicillin use in primary and secondary syphilis.A severe ulcerative form of secondary syphilis termed lues maligna has also been described with severe immunosuppression.Increased likelihood of chancres at the same time as symptoms of secondary syphilis.
The early stages of syphilis have been reported to overlap more frequently in people with HIV.HIV infection may modulate the cutaneous presentation of syphilis (e.g.They range from small to very large and may be severe. Gummatous syphilis: gummas may present as ulcers or heaped up granulomatous lesions with a round, irregular or serpiginous shape. Large, raised, grey-to-white lesions called condylomata lata may develop in warm, moist areas such as the mouth and perineum.Mucous patches, whitish erosions on the oral mucosa or tongue, and split papules at the oral commissures.Involvement of the palms and soles (syphilids or copper spots).Cutaneous manifestations include rashes which can take any form and may resemble:.At the site of inoculation, a papule might appear which soon ulcerates to produce a chancre, a 1 to 2-cm ulcer with a raised, indurated margin.Haemorrhagic lesions, erythema nodosum, urticaria and erythema multiforme occur less frequently.Lesions include micro-abscesses, macules, papules, pustules and vesicles.It affects the trunk, limbs, palms and soles, and usually spares the face, scalp and mouth. A rash is present in most patients with disseminated gonococcal infection.Nail changes including nail thickening and onycholysis.Erythematous genital lesions and shallow ulcers affecting the glans penis (circinate balanitis).Tender, thickened skin and scaly patches involving the soles of the feet and lower legs (keratoderma blenorrhagicum).Sexually acquired reactive arthritis (SARA) following either C.
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