Presternal Indurated Ulceration: Primary Syphilis

Lautenschlager, Stephan; Schwarzkopf, Stefan; Borelli, Siegfried

doi:10.1159/000090663

Cited by 9 publications

(3 citation statements)

References 19 publications

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“…Due to the increasing popularity of oral sex in recent years -in part because it supposedly is a safer-sex practice -an increase of oral chancres has been observed. Case reports describe syphilitic chancres of fingers, mammillae, eyelid, arm, toe or presternal region ( Figure 3) [6,15,[18][19][20]. Decades ago extragenital chancres were no rarity; Fournier describes 642 from head to toe in his textbook [21].…”

Section: B) Atypical Locationmentioning

confidence: 99%

Diagnosis of syphilis: Clinical and laboratory problems

Lautenschlager

2006

J Deutsche Derma Gesell

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Section: B) Atypical Locationmentioning

confidence: 99%

Diagnosis of syphilis: Clinical and laboratory problems

Lautenschlager

2006

J Deutsche Derma Gesell

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“…The clinical diagnosis of syphilis at any stage of its evolution is not always obvious [12,13]. When the clinical diagnosis of syphilis is not established, a skin biopsy is sometimes submitted to the dermatopathologist without relevant information.…”

Section: Introductionmentioning

confidence: 99%

Perivascular Cuff and Spread of <i>Treponema pallidum</i>

Quatresooz

Pierard

2009

Dermatology

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Background: The incidence of syphilis is on the rise in many cities worldwide. Both the clinical and histopathological changes do not always fulfil the typical diagnostic criteria. Immunohistochemistry is available to identify and localize Treponema pallidum. Two main patterns of T. pallidum distribution were described in the skin, namely heavy intraepidermal infiltration and scattered pattern inside the lichenoid cell infiltrate. Objective: To search for a third pattern consistent with dissemination of the disease. Methods: Immunohistochemistry using an antispirochete (T. pallidum and Borrelia) antibody was used in all cases of syphilis submitted to our laboratory. In addition, deposits of immunoglobulins and complement indicative of immune complexes were searched for. Results: According to the cases, T. pallidum was disclosed in a combination of three patterns. The previously described epidermal and lichenoid patterns were confirmed, and a third pattern predominating in a perivascular location throughout the dermis was clearly identified in primary syphilis. The microorganisms were abundant in extracellular and intracellular locations, particularly inside endothelial cells. No deposits of immunoglobulins and complement were disclosed. Conclusion: The perivascular cuff of T. pallidum throughout the dermis might be representative of the dissemination phase of T. pallidum.

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“…Early syphilis is a highly infectious sexually transmitted disease, in which the lesions heal spontaneously, while the patient is still contagious. Since the initial presentation may be extragenital [2] , it is important to include syphilis in the differential diagnosis of patients with atypical skin ulceration. Here, we report a case with the unusual presentation of syphilis on the finger.…”

Section: Introductionmentioning

confidence: 99%