Comparative Studies on the Histo-Pathology of Syphilis, Yaws, and Pinta

Skin Infections

“…190 The secondary form is associated with epidermal hyperplasia and papillomatosis, and the infiltrate is again diffuse without vasculopathy. In the dermis, there is a striking infiltrate of lymphoid cells, with histiocytes and plasma cells and scattered neutrophils and eosinophils.…”

“…190,191 Pinta Pinta is the only treponemal condition that affects the skin only. Silver stains reveal the organisms to be present between keratinocytes, but they do not appear in the dermis.…”

The Endemic Treponematoses

“…The dermal inflammatory infiltrate is located perivascularly and is composed of lymphocytes and plasma cells. Granulomas consisting of epithelioid cells and multinuclear giant cells might be present (25,65). With regard to the histopathological picture of late bejel lesions, one study of three cases of late mutilating disease showed parakeratosis, acanthosis, spongiosis, and an inflammatory infiltrate of epithelioid cells, lymphocytes, and plasma cells (48), again similar to syphilis.…”

“…The inflammatory infiltrate localizes in the upper dermis around enlarged blood vessels and is composed of lymphocytes, plasma cells, and neutrophils. Melanophages can also infiltrate the dermis (25,62,65). The histopathology of the pintids differs according to their appearance.…”

“…With the aid of silver staining, treponemes can be visualized in the intercellular spaces of the epidermis, among inflammatory cells, and within the dermis. The histopathology of late yaws lesions resembles that of tertiary syphilis, with the presence of granulomas associated with necrotic areas (64,65).…”