Secondary Syphilis in a 12-Year-Old Girl Misdiagnosed as Pityriasis Lichenoides et Varioliformis Acuta: A Case Report

    July 2021 in “ Clinical Cosmetic and Investigational Dermatology ”
    Min Zhang, Jia Yu, Hui Huang, Cunjian Zhou, Zhifang Zhai, Yi You, Zhiqiang Song
    TLDR Syphilis should be considered if PLEVA-like symptoms don't improve with treatment.
    A 12-year-old girl was initially misdiagnosed with pityriasis lichenoides et varioliformis acuta (PLEVA) but was later diagnosed with secondary syphilis, potentially involving neurosyphilis. She exhibited symptoms such as a systemic rash, hair loss, arthralgia, and fatigue, and did not respond to PLEVA treatment. The correct diagnosis was confirmed through serologic and cerebrospinal fluid tests. Following neurosyphilis therapy, her symptoms improved significantly. This case underscored the need to consider syphilis in differential diagnoses for patients with PLEVA-like symptoms unresponsive to standard treatments.
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