Granulomatous Secondary Syphilis: An Uncommon Presentation of the Great Imitator

Yousefian, Faraz; Wang, Hayoung; Yadlapati, Sujitha; Browning, John

doi:10.1016/j.amjmed.2022.09.014

Cited by 4 publications

(3 citation statements)

References 2 publications

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Section: Discussionmentioning

confidence: 99%

“…We performed a literature review of cases of granulomatous secondary syphilis in which the diagnostic work-up included immunohistochemistry for the detection of spirochetes in skin biopsy specimens. Table 1 summarises the main findings observed in these cases [2,3,5,6,[15][16][17][18][19][20][21][22][23]. The literature search was performed in the PubMed database using the keywords 'granuloma' and 'syphilis' or 'granulomatous syphilis' and was limited to articles written in English and published until March 2023.…”

Section: Discussionmentioning

confidence: 99%

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Granulomatous Secondary Syphilis: A Case Report with a Brief Overview of the Diagnostic Role of Immunohistochemistry

Ambrogio,

Cazzato,

Foti

et al. 2023

Pathogens

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The diagnosis of syphilis can be challenging for dermatologists and dermatopathologists. In particular, secondary syphilis can have different clinical and histopathological presentations. A granulomatous tissue response is an unusual finding in secondary syphilis. We report the case of a 77-year-old man who presented with a 4-week history of non-pruritic generalised macules, papules, nodules and plaques. Histopathologically, there was a dense perivascular and periadnexal lympho-histiocytic dermal infiltrate with non-palisading and non-caseifying epithelioid granulomas and abundant plasma cells. The diagnosis of syphilis was confirmed by serology and immunohistochemical detection of Treponema pallidum in the biopsy specimen. A brief overview of the diagnostic role of immunohistochemistry is also provided, with particular emphasis on reported cases of granulomatous secondary syphilis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Granulomatous Secondary Syphilis: A Case Report with a Brief Overview of the Diagnostic Role of Immunohistochemistry

Ambrogio,

Cazzato,

Foti

et al. 2023

Pathogens

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“…Cases of atypical primary syphilis misdiagnosed as pharyngeal lymphoma, tongue cancer, and other types of oral squamous cell carcinomas have been described [39][40][41]; however, the secondary stage of the disease, given the possible involvement of the whole skin area and of other organs, is the one that is most prone to misdiagnosis like palmoplantar psoriasis, psoriasis vulgaris, erythema multiforme, cutaneous lymphoma, and granulomatous diseases of the skin (annular granuloma, sarcoidosis). Moreover, involvement of internal organs with signs and symptoms of osteomyelitis, nephrotic syndrome, retinitis, and others has been reported in secondary syphilis with or without typical cutaneous/mucosal involvement, further complicating the clinical picture [42][43][44][45][46][47]. In regards to neurosyphilis, a recent narrative review revealed a low level of clinical awareness of T. pallidum infection as a possible etiology of various psychiatric disorders including dementia, delirium, depression, mania, personality changes, and psychosis.…”

Section: Discussionmentioning

confidence: 99%

Atypical Manifestations of Syphilis: A 10-Year Retrospective Study

Ciccarese,

Facciorusso,

Mastrolonardo

et al. 2024

JCM

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Background: The incidence of syphilis has increased in high-income countries in the past few decades, especially among men who have sex with men. In the present study, we aimed to analyze the correlations between atypical syphilis manifestations and the demographic, clinical, and laboratory features of patients and to review unusual presentations of syphilis reported in the literature. Methods: We conducted a retrospective analysis of 307 patients with syphilis diagnosed between 1 January 2013 and 31 October 2023 at the sexually transmitted infection (STI) centers of the University of Genoa and University of Foggia with both typical and atypical manifestations of disease. Results: In our series, atypical manifestations were detected in 25.8% of the patients, especially in the secondary stage of the disease. Lesions with annular morphology and lesions presenting as itchy erythematous scaly plaques with a psoriasiform appearance were the most common atypical presentations of secondary syphilis. A statistical analysis revealed that homosexual orientation, syphilis reinfection, and venereal disease research laboratory (VDRL) titers > 1:32 were correlated with atypical manifestations. Conclusions: Our study demonstrates that the spectrum of syphilis manifestations, in all the stages of the disease, is wide; atypical manifestations often pose diagnostic challenges, may delay the provision of appropriate treatment, and facilitate the spread of the infection.

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Is Benzathine Penicillin the Treatment of Choice in Neurosyphilis?

Gozdas,

Dogan

2023

The American Journal of Medicine

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Granulomatous Secondary Syphilis: An Uncommon Presentation of the Great Imitator

Cited by 4 publications

References 2 publications

Granulomatous Secondary Syphilis: A Case Report with a Brief Overview of the Diagnostic Role of Immunohistochemistry

Granulomatous Secondary Syphilis: A Case Report with a Brief Overview of the Diagnostic Role of Immunohistochemistry

Atypical Manifestations of Syphilis: A 10-Year Retrospective Study

Is Benzathine Penicillin the Treatment of Choice in Neurosyphilis?

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