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Notable Notes
Dec 2011

Imitator and H ér édo: Synonyms for Syphilis ’ Clinical Symptoms

Author Affiliations

Author Affiliations: National Research Council of Italy, Institute of Neurological Sciences, Mangone (Cosenza), Italy.

Arch Dermatol. 2011;147(12):1442. doi:10.1001/archderm.147.12.1442

During his long surgical career, Jonathan Hutchinson1 (1828-1913) described syphilis as showing manifold clinical symptoms that mimic other diseases, such as cheiropompholyx or dyshidrosis (or Hutchinson disease), summer itch, lupus marginatus (Hilliard lupus, named for the index case), and sarcoidosis. The term imitator includes other infectious diseases, such as syphilitic roseola, which mimics measles; diffuse erythematous lichen for scarlatina; and pustular rash for smallpox. In 1879, Hutchinson2,3 defined syphilis as the imitator for the first time: