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Peer-reviewedCC BYCureus

Rupioid Syphilis Beyond Immunosuppression: A Systematic Review of Cases in HIV-Negative Patients.

  • Erica K Rankin1
  • Chad Gentry1
  • Alexandra Daily1
  • Julianna Foss1
  • Aishwi Patel1
  • Dalton Shepherd1
  • Kelsey Voss1
  • Julia Juriga1
  • Kimberly A Kluglein2
  • Suzanne I Riskin1
  1. 1Medicine, Department of Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.
  2. 2Dermatology, Hospital Corporation of America (HCA) Healthcare Florida Largo Hospital/University of South Florida (USF) Morsani College of Medicine, Largo, USA.
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Abstract

Rupioid syphilis (malignant syphilis or lues maligna) is a severe ulcero-nodular manifestation of infection originating from Treponema pallidum. It is typically associated with immunosuppressed states, notably those derived from HIV co-infection. This systematic review aims to highlight the rare instances in which this multi-faceted disease affects those with HIV seronegative immune status. A review of cases was conducted using PubMed, Embase, and Web of Science databases with Boolean operators utilizing all variants of "malignant syphilis" or "lues maligna" or "rupioid syphilis" combined with "immunocompetent." Relevant studies included those from inception through August 2026. After removal of duplicates and screening, a total of 20 cases were selected based on inclusion criteria. The results revealed consistent clinical features, including systemic symptoms and ulcerative-necrotic lesions in 20 patients lacking underlying HIV immunosuppression. These findings underscore the importance of maintaining high clinical suspicion for syphilis in patients presenting with necrotic papuloulcerative lesions and systemic manifestations, regardless of HIV status, to ensure timely diagnosis and management.

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Cite

BibTeXRIS
BibTeX
@article{rankin2026rupioid,
  title = {{Rupioid Syphilis Beyond Immunosuppression: A Systematic Review of Cases in HIV-Negative Patients.}},
  author = {Erica K Rankin and Chad Gentry and Alexandra Daily and Julianna Foss and Aishwi Patel and Dalton Shepherd and Kelsey Voss and Julia Juriga and Kimberly A Kluglein and Suzanne I Riskin},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116910},
  url = {https://europepmc.org/article/MED/42928870},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Rupioid Syphilis Beyond Immunosuppression: A Systematic Review of Cases in HIV-Negative Patients.
AU  - Erica K Rankin
AU  - Chad Gentry
AU  - Alexandra Daily
AU  - Julianna Foss
AU  - Aishwi Patel
AU  - Dalton Shepherd
AU  - Kelsey Voss
AU  - Julia Juriga
AU  - Kimberly A Kluglein
AU  - Suzanne I Riskin
PY  - 2026
DA  - 2026/09/25
JO  - Cureus
DO  - 10.7759/cureus.116910
UR  - https://europepmc.org/article/MED/42928870
AB  - Rupioid syphilis (malignant syphilis or lues maligna) is a severe ulcero-nodular manifestation of infection originating from Treponema pallidum. It is typically associated with immunosuppressed states, notably those derived from HIV co-infection. This systematic review aims to highlight the rare instances in which this multi-faceted disease affects those with HIV seronegative immune status. A review of cases was conducted using PubMed, Embase, and Web of Science databases with Boolean operators utilizing all variants of "malignant syphilis" or "lues maligna" or "rupioid syphilis" combined with "immunocompetent." Relevant studies included those from inception through August 2026. After removal of duplicates and screening, a total of 20 cases were selected based on inclusion criteria. The results revealed consistent clinical features, including systemic symptoms and ulcerative-necrotic lesions in 20 patients lacking underlying HIV immunosuppression. These findings underscore the importance of maintaining high clinical suspicion for syphilis in patients presenting with necrotic papuloulcerative lesions and systemic manifestations, regardless of HIV status, to ensure timely diagnosis and management.
SN  - 2168-8184
ER  -