STI: malignant syphilis: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · STI: malignant syphilis

Sample item

An HIV-positive man has fever and widespread necrotic ulcerated nodules with rupioid crusts. VDRL is strongly reactive at high titre. Which diagnosis fits?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Lues maligna (malignant syphilis)

Lues maligna is an uncommon severe form of secondary syphilis with necrotic ulcerating lesions and rupioid crusts, often seen in HIV infection. VDRL titres are very high and a Jarisch-Herxheimer reaction can follow treatment. Benzathine penicillin is the treatment.

Option by option

  • A. Pyoderma gangrenosum

    Pyoderma gangrenosum has negative syphilis serology.

  • B. Chancroid

    Chancroid is painful with soft ulcers and buboes.

  • C. Lues maligna (malignant syphilis) (correct)

    Correct. Necrotic rupioid lesions with high-titre serology indicate lues maligna.

  • D. Primary syphilitic chancre

    A chancre is a solitary painless ulcer.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Lues maligna (malignant syphilis). Lues maligna is an uncommon severe form of secondary syphilis with necrotic ulcerating lesions and rupioid crusts, often seen in HIV infection.

Why is "Pyoderma gangrenosum" not the answer?

Pyoderma gangrenosum has negative syphilis serology.

Why is "Chancroid" not the answer?

Chancroid is painful with soft ulcers and buboes.

Why is "Primary syphilitic chancre" not the answer?

A chancre is a solitary painless ulcer.

What concept does this question test?

It tests STI: malignant syphilis in Dermatology. VDRL titres are very high and a Jarisch-Herxheimer reaction can follow treatment. Benzathine penicillin is the treatment.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study STI: malignant syphilis?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.