A rare image of post syphilis nodulo ulcerative lesions over right foot

¹Department of Kayachikitsa, Mahatma Gandhi Ayurved College and Research Centre, Datta Meghe Institute of Higher Education and Research, Salod (H), Wardha, Maharashtra, India

^&Corresponding author
Aishwarya Kadam, Department of Kayachikitsa, Mahatma Gandhi Ayurved College and Research Centre, Datta Meghe Institute of Higher Education and Research, Salod (H), Wardha, Maharashtra, India

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Syphilis is a bacterial infection caused by Treponema pallidum, primarily transmitted through sexual contact. It spreads via direct contact with sores, which are often painless. The disease progresses in stages, each presenting different symptoms. In the primary stage, a characteristic symptom called a Chancre (small sore) appears, with some individuals developing a single sore while others may have multiple. Common symptoms include wart-like sores or rashes on the genitals or other parts of the body, with or without pain. This case presented a 54-year-old female with multiple progressive erythematous ulcerative lesions on her right foot, which had been worsening over the past three months, accompanied by itching and a burning sensation. She also reported smaller, similar lesions in the genital area. The patient had a history of syphilis diagnosed nine months earlier. She underwent treatment with Doxycycline 100 mg twice daily for three months, but had no satisfactory relief. On examination and followed by a history of syphilis, the patient was diagnosed with post-syphilis nodulo-ulcerative lesions over the right foot, as shown in the image. After that, the patient was advised for therapeutic purgation using tablet Icchabhedi Rasa, therapeutic cleansing of the vaginal tract using herbal decoction of Triphala Kwath and Panchatikta Ghrita used for both local application and oral consumption (2 teaspoons on an empty stomach with lukewarm water). Additionally, she was prescribed tablet Sutshekhar Rasa (two tablets, three times a day) for one month. The treatment led to a significant reduction in lesion size and overall improvement. The image is useful in differentiating between atopic dermatitis, chromoblastocytosis, eczematous skin disorder, primary inoculation tuberculosis, and nodulo-ulcerative lesion.

Figure 1: post syphilis nodulo ulcerative lesions over right foot