A rare Case of Psoriasis Vulgaris with Kaposi Varicelliform Eruptions Secondary to Second-Degree Syphilis

Abstract

Psoriasis is an immune-mediated inflammatory skin disease that can cause sharply demarcated, erythematous, and scaly skin lesions often found on the surface of the skin (Nair & Badri, 2025). Although the exact origins of the condition are unknown, environmental and genetic factors may play a role. Numerous genes, including human leukocyte antigen (HLA)-Cw6, loci for the T-helper type 2 and T-helper type 17 pathways, innate immune signaling pathways, and adaptive immune pathways involving CD8 T cells, have recently been identified as potentially linked to psoriasis (Chhabra et al., 2022; Li et al., 2016). The incidence rate varies depending on the country-to-country basis, but it generally falls between 2% and 3% (Damiani et al., 2021). Kaposi varicelliform eruptions (KVE) is a cutaneous infection that is generally caused by a variety of viruses such as herpes simplex virus types 1 and 2 and coxsackievirus A16 in patients with underlying dermatosis. Although the exact pathology of KVE is unclear, the breakdown of the body's defense mechanisms and altered skin barriers could be a potential factor (Çakmak et al., 2015). Antiviral medication with acyclovir is a treatment of choice that is generally combined with antibiotics. However, in some rare cases, mortality can also be reported in the case of systemic viremia (Thappa et al., 2011). On the other hand, severe psoriasis can be life-threatening if an early diagnosis is not made and if associated with various other health issues. Since psoriasis cannot be cured, avoiding triggers, such as changing one's lifestyle and using moisturizers to prevent dry skin, is crucial. However, some of the treatment options available for psoriasis are phototherapy or systemic treatment, topical therapy, corticosteroid treatment, immunotherapy, and methotrexate (Raharja et al., 2021; Cleveland Clinic, 2025). A 28-year-old male person was brought to the hospital with itchy skin and lesions all over the body. He was normal four months ago until he got several hyperpigmented papules on his left hand. These papules quickly spread to other parts of his body within four months, and he also experienced intermittent fever, gradual weight loss, and decreased hearing starting at three to four weeks. After the investigation, it was found that he was suffering from psoriasis vulgaris with Kaposi varicelliform eruptions secondary to second-degree syphilis. Differential Diagnosis: Pityriasis rosea, seborrheic dermatitis, eczema, rickettial infection, chickenpox