Granulomatous Form of Rosacea in a Patient with Syphilis and HIV Infection

Abstract

Rosacea is a chronic inflammatory dermatosis characterized by erythema and papulopustular elements on the face. The aim of the study is to demonstrate a clinical case of granulomatous rosacea with syphilis and HIV infection. We present a clinical case of granulomatous rosacea against the background of early latent syphilis and newly diagnosed HIV infection. The skin process has a limited symmetric character, localized on the whole surface of the face except for the periorbital areas. It is represented by monomorphic confluent brown and red papules and pustules up to 0.5 cm in diameter on a background of erythema and moderate edema. On the lower lip on the left side there is an erosion in the stage of epithelization. Immune system dysfunction may contribute to chronic inflammation and vascular abnormalities in rosacea. An association between demodex infection and rosacea has been found. Also, defective cellular immunity caused by HIV infection may play an important role in the pathogenesis of malignant syphilis. Long-standing, treatment-resistant dermatoses require testing of the patient for syphilis and HIV infection. The presence of HIV in the blood contributes to the clinical manifestation of demodecosis, which can lead to a persistent granulomatous form of rosacea.