Condyloma Lata: A Vulvar Manifestation of Secondary Syphilis

Abstract

In the initial decades of the 21st century, a rise in the incidence of syphilis has been observed in all developed countries. This disease has become not only a public health concern, but also a problem in clinical practice, since clinicians need to have sufficient knowledge and experience for an early diagnosis and treatment. Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum. In secondary syphilis, condyloma lata, a papular lesion typical of this stage of the disease, has been reported in 6% to 23% of patients. Here we present two cases of patients diagnosed with secondary syphilis, who presented condyloma lata on the vulvar area as the first clinical manifestation. Biopsy of lesions and observation with dark-field microscopy revealed abundant spirochetes. It was not an easy diagnosis either for the clinician and the pathologist as it can be similar to other dermatological conditions, such as anogenital warts (condyloma acuminata). Patients were treated with penicillin until complete resolution of the clinical signs. Secondary syphilis is currently uncommon in developed countries, especially with condyloma lata as the first clinical manifestation.

J Clin Gynecol Obstet. 2024;13(2):41-47
doi: https://doi.org/10.14740/jcgo960