Histologic features of secondary syphilis: A multicenter retrospective review

Flamm, Alexandra; Parikh, Kruti; Xie, Qingguo; Kwon, Eun Ji; Elston, Dirk M.

doi:10.1016/j.jaad.2015.08.062

Cited by 55 publications

(60 citation statements)

References 10 publications

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“…Many patients do not seek medical attention during the primary stage of syphilis as the chancre is painless and it may not be readily noticed. As mentioned earlier, the histopathologic findings of secondary syphilis are quite characteristic, and psoriasiform hyperplasia with elongated slender rete ridges was found in 75.5% of cases, plasma cells in 69.8% of cases and endothelial swelling in 87.7% of cases . Here, we present a rare case of late latent mucinous syphilis with disseminated cutaneous lesions, which mimics connective tissue disease histopathologically and could represent a diagnostic pitfall.…”

Section: Discussionsupporting

confidence: 58%

“…A diagnosis of syphilis was reached in the patient because of having high clinical suspicion for sexually transmitted infection in a homosexual male with elevated inflammatory markers and partner with positive history of syphilis. While immunohistochemistry for Treponema pallidum has sensitivity of 71% and is readily found in primary and secondary syphilis, spirochetes are rarely identified in latent syphilis and this is well showed in our case, where only a single spirochete was present near a dermal capillary. The patient's positive review of systems and the disappearance of the ophthalmologic symptoms after the first intramuscular injection of benzathine penicillin G lend further support to the diagnosis.…”

Section: Discussionsupporting

confidence: 52%

“…FTA‐ABS should be carefully used in patients with SLE and rheumatic diseases as it too can be falsely positive, and additional tests such as treponemal Western blot should be performed for confirmation . Skin biopsy of a secondary syphilis lesion is quite characteristic where acanthotic, psoriasiform dermatitis with elongated slender rete ridges, dense superficial and deep perivascular lymphocytic infiltrate with numerous plasma cells and endothelial swelling are observed . Syphilis was at an all time low at the turn of the century in United States; however, recently a resurgence of cases has been seen .…”

Section: Introductionmentioning

confidence: 99%

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Late latent mucinous syphilis mimicking connective tissue disease

Gottesman

Schoenling²,

Culpepper

2017

J Cutan Pathol

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As evidenced by the Centers for Disease Control and Prevention (CDC) statistics, syphilis is yet again on the rise. It is known as the great mimicker because of its variable symptoms and how frequently it can be confused with other diseases. The different stages of syphilis (primary, secondary, latent, late latent and tertiary) are discussed. We describe a new histopathologic pattern of syphilis, one that mimics connective tissue disease and can represent a diagnostic pitfall. In this time and age, when syphilis is rising especially among the men who have sex with men subgroup, it is important to keep a high index of suspicion of syphilis even when clinically and histopathologically the findings on first glance may not appear characteristic.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

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Late latent mucinous syphilis mimicking connective tissue disease

Gottesman

Schoenling²,

Culpepper

2017

J Cutan Pathol

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“…The histological diagnosis of cutaneous lymphomas is based on histomorphologic criteria, immunohistochemical staining profile, results of Some subtle histomorphologic clues for secondary syphilis (interstitial inflammatory pattern, endothelial swelling and irregular acanthosis) 8 were a hint to the correct diagnosis. Moreover, the high number of admixed plasma cells was additionally helpful.…”

Section: Discussionmentioning

confidence: 99%

“…9 On the other hand, plasma cells in secondary syphilis are detectable only in 70% of the cases. 8 Furthermore, an almost complete loss of CD4-positive T-cells should make one think of HIV-associated PSL. 6 CD8-positive PSL in HIV patients have rarely been described.…”

Section: Discussionmentioning

confidence: 99%

CD8‐positive pseudolymphoma in lues maligna and human immunodeficiency virus with monoclonal T‐cell receptor‐beta rearrangement

Mitteldorf¹,

Plumbaum

Zutt

et al. 2018

J Cutan Pathol

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A 42‐year‐old Caucasian man suffered from disseminated plaques and ulcerated nodules for 6 weeks. He had weight loss and generalized lymphadenopathy. Underlying diseases were not known up till then. Based on a skin biopsy, the diagnosis of CD8‐positive cutaneous T‐cell lymphoma, type mycosis fungoides was made in a pathological reference center for lymphoma. A reproducible T‐cell receptor (TCR)‐beta rearrangement was detectable. Before starting therapy, a new biopsy was taken and the previous diagnosis was re‐evaluated taking clinical images and symptoms into account. Based on both, the diagnosis of a CD8+ pseudolymphoma in lues maligna and human immunodeficiency virus was made. We highlight histopathologic clues for the correct diagnosis, and we emphasize the indispensability of clinical‐pathological correlation. Furthermore, we discuss the differential diagnosis of CD8+ lymphoproliferative disorders.

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Possible effects of Treponema pallidum infection on human vascular endothelial cells

Xie

Zhao

et al. 2022

Clinical Laboratory Analysis

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Treponema pallidum belongs to the Spirochaetaceae (spirochetes), ranging from 6 to 15 µm in length, with a diameter of 0.2 µm. It can cause syphilis, a sexually transmitted disease with multiple stages and development that seriously endangers human health, causing 6.3 million new infections each year. 1 Treponema pallidum directly across the mucous membranes of the host or broken skin caused by sexual activity. From a series of previous bioinformatics analyses related to genomics of T. pallidum, it can be seen that T. pallidum lacks a complete biosynthetic pathway, 2,3 which may not satisfy its own needs for survival in the host, so T. pallidum obtains important or essential macromolecules during the infection of host cells. At the same time, the barrier function of the vascular endothelium of the host is destroyed, allowing it to enter the blood and then spread to the distal tissues and organs through flow of blood. 4 Therefore, T. pallidum attaching to and altering host cells (such as endothelial cells) and extracellular matrix are a key initial steps for infection.Treponema pallidum bind to vascular endothelial receptors (unfortunately, the specific receptors are still unknown) by the bacteria adhesion protein (adhesins such as Tp0751, Tp0136, and Tp0155.) (Table 1) to penetrate tissue barriers, such as the intima of vascular endothelium. [5][6][7] It has also been determined that TP0326/Tp92 is a T. pallidum outer membrane protein, and it is presumed that Tp92 also helps T. pallidum attach to host endothelial cells according to the function of homologous protein for mediating cell adhesion. 8 Treponema pallidum then spreads throughout the whole body utilizing blood circulation through tissue and vascular endothelial barriers (e.g., blood-brain barrier and placental barrier), causing multiple organ and tissue infections. 9 However, it

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Histologic features of secondary syphilis: A multicenter retrospective review

Cited by 55 publications

References 10 publications

Late latent mucinous syphilis mimicking connective tissue disease

Late latent mucinous syphilis mimicking connective tissue disease

CD8‐positive pseudolymphoma in lues maligna and human immunodeficiency virus with monoclonal T‐cell receptor‐beta rearrangement

Possible effects of Treponema pallidum infection on human vascular endothelial cells

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