Olympian brown and rhagdes are seen in-
CMV inclusion disease
Ectodermal dysplasia
Congenital syphilis
Hyper IgE syndrome
Ans. c. Congenital syphilisClinical Presentation of SyphilisEarly Congenital Syphilis:Snuffles (rhinitis)Q is earliest feature.Lesions are vesicobullousQ, and snail track ulcers on mucosaClinical Presentation of SyphilisLate Congenital Syphilis:Characterized by Hutchinson's triad (interstitial keratitis + 8th nerve deafness + Hutchinson's teeth i.e. peggedcentral upper incisors)QSaddle nose, sabre tibia, mulberry molarsQBull dog's jaw (protrusion of jaw)Rhagadesdeg (linear fissure at mouth, nares)Frontal bossing, hot cross bun deformity of skullClutton's jointdeg (painless swelling of joints, most commonly both knee)Palatal perforationdegHigaumenakis sign (periostitis leads to unilateral enlargement of sterna end of clavicle)Primary Syphilis:Painless, indurated, nonbleeding, usually single punched out ulcer (hard chancre)QPainless, rubbery shotty lymphadenopathySecondary Syphilis:Bilateral symmetrical asymptomatic localized or diffuse mucocutaneous lesiondeg (macule, papule, paulosquamousand rarely pustule)Non-tender generalized lymphadenopathyQHighly infectious condylomata late, in warm moist interiginous areasMoth eaten alopecia, ahritis, proteinuriaQTeiary Syphilis:Gumma, neurosyphilis/tabes dorsalisQOstitis, periostitisAoitis, aoic insufficiency, coronary stenosis and nocturnal anginaQ