Tertiary syphilis: tubero-serpiginous and tubero-ulcerous syphilids

Jorge, Lívia Montelo Araújo; Nery, José Augusto da Costa; Filho, Fred Bernardes

doi:10.1016/j.bjid.2016.01.007

Cited by 3 publications

(6 citation statements)

References 6 publications

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“…16,21,22 In any stage of syphilis, it is possible to have an asymptomatic or symptomatic neurologic involvement with abnormal cerebrospinal fluid findings. 14,16 Tertiary Syphilis Tertiary, or late syphilis, is a systemic, multiorgan evaluation that occurs in approximately one-third of untreated but infected patients, 23,24 after a period of years or even decades, including late neurosyphilis (general paresis or tabes dorsalis), cardiovascular syphilis, or gummatous syphilis. Cutaneous lesions (noduloulcerative or gummatous) occur in 16% of patients with late clinical manifestations; these are usually single, unilateral, and asymptomatic.…”

Section: Latent Syphilismentioning

confidence: 99%

“…Cutaneous lesions (noduloulcerative or gummatous) occur in 16% of patients with late clinical manifestations; these are usually single, unilateral, and asymptomatic. 23,24 Noduloulcerative lesions are superficial brown nodules, with serpiginous ulcerative evolution and central resolution. On the other side, gummas are painless destructive rubbery nodules that evolve into punched out ulcers that can grow to many centimetres and that drain necrotic material, invading deeply into tissue and bone, and healing with deeply retracted scars.…”

Section: Latent Syphilismentioning

confidence: 99%

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Syphilis Diagnosis and Treatment: State of The Art

Trovato

Tognetti

Campoli

et al. 2021

EMJ

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The present review summarises the current knowledge in the field of syphilis diagnosis and treatment, along with epidemiologic and historical data. A literature search was conducted in PubMed and Google Scholar, using the search terms “syphilis”, “diagnosis”, “dermoscopy”, “management AND treatment”, “laboratory tests AND syphilis”, and “primary OR secondary OR tertiary OR congenital syphilis”. A total of 55 out of 100 papers were included in this review. An overview of the different clinical presentation of primary, secondary, tertiary, and congenital syphilis, with particular attention to dermatologic signs and dermoscopic examination, is provided. The panorama diagnostic procedures are illustrated, along with their accuracy and recommendation. Treatment and management options of patients at different syphilis stages are provided and discussed according to the referring guidelines. The dermatologist can play a key role in providing the early and correct diagnosis and setting up in the proper management of patients with syphilis infection.

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Section: Latent Syphilismentioning

confidence: 99%

Section: Latent Syphilismentioning

confidence: 99%

Syphilis Diagnosis and Treatment: State of The Art

Trovato

Tognetti

Campoli

et al. 2021

EMJ

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“…Late symptomatic syphilis is a rare systemic disease that can affect the skin, the mucous membranes, the circulatory system, the nervous system and the skeletal system. The incidence of tertiary syphilis decreases significantly with the introduction of penicillin in its early stage, but new cases of this disease are still being reported [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ,…”

Section: Discussionmentioning

confidence: 99%

“…In order to illustrate this issue, the PubMed database was searched for cases of tertiary syphilis in the last 10 years. 22 cases of late skin syphilis (including one in Poland) [ 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 47 ], 21 cases of cardiovascular system syphilis [ 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ], five cases of systemic syphilis (the liver, the pancreas, the adrenal glands) [ 73 , 74 , 75 , 76 , 77 ], 11 cases of syphilis affecting bones [ 41 , 42 , 43 , 44 , 45 , 46 ,…”

Section: Discussionmentioning

confidence: 99%

“…Syphilis can be divided into primary and secondary stage early syphilis (within one year of infection), and late latent and symptomatic syphilis [ 10 ]. The number of cases of late symptomatic syphilis have dropped significantly since the implementation of penicillin to treat early syphilis [ 11 ], but occasional cases of tertiary syphilis are still noted [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ,…”

Section: Introductionmentioning

confidence: 99%

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Challenges in the Diagnosis of Tertiary Syphilis: Case Report with Literature Review

Jankowska

Adamski

Polańska

et al. 2022

IJERPH

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Tertiary syphilis is a large diagnostic challenge. It is rarely the case that it affects the skin, bone tissue and the eyes at the same time. The presented case shows that extensive symptomatology of syphilis poses a challenge in making a proper diagnosis in patients whose history does not suspect STDs. The study aims to present the case of a young woman hospitalized with a suspected autoimmune disease, diagnosed with symptomatic late syphilis with involvement of the skin, bones and eyes.

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Phosphorylated vimentin-triggered fibronectin matrix disaggregation enhances the dissemination of Treponema pallidum subsp. pallidum across the microvascular endothelial barrier

Luo,

Zhang,

Xie

et al. 2024

PLoS Pathog

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Fibronectin (FN) is an essential component of the extracellular matrix (ECM) that protects the integrity of the microvascular endothelial barrier (MEB). However, Treponema pallidum subsp. pallidum (Tp) breaches this barrier through elusive mechanisms and rapidly disseminates throughout the host. We aimed to understand the impact of Tp on the surrounding FN matrix of MEB and the underlying mechanisms of this effect. In this study, immunofluorescence assays (IF) were conducted to assess the integrity of the FN matrix surrounding human microvascular endothelial cell-1 (HMEC-1) with/without Tp co-culture, revealing that only live Tp exhibited the capability to mediate FN matrix disaggregation in HMEC-1. Western blotting and IF were employed to determine the protein levels associated with the FN matrix during Tp infection, which showed the unaltered protein levels of total FN and its receptor integrin α5β1, along with reduced insoluble FN and increased soluble FN. Simultaneously, the integrin α5β1-binding protein–intracellular vimentin maintained a stable total protein level while exhibiting an increase in the soluble form, specifically mediated by the phosphorylation of its 39th residue (pSer39-vimentin). Besides, this process of vimentin phosphorylation, which could be hindered by a serine-to-alanine mutation or inhibition of phosphorylated-AKT1 (pAKT1), promoted intracellular vimentin rearrangement and FN matrix disaggregation. Moreover, within the introduction of additional cellular FN rather than other Tp-adhered ECM protein, in vitro endothelial barrier traversal experiment and in vivo syphilitic infectivity test demonstrated that viable Tp was effectively prevented from penetrating the in vitro MEB or disseminating in Tp-challenged rabbits. This investigation revealed the active pAKT1/pSer39-vimentin signal triggered by live Tp to expedite the disaggregation of the FN matrix and highlighted the importance of FN matrix stability in syphilis, thereby providing a novel perspective on ECM disruption mechanisms that facilitate Tp dissemination across the MEB.

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Tertiary syphilis: tubero-serpiginous and tubero-ulcerous syphilids

Cited by 3 publications

References 6 publications

Syphilis Diagnosis and Treatment: State of The Art

Syphilis Diagnosis and Treatment: State of The Art

Challenges in the Diagnosis of Tertiary Syphilis: Case Report with Literature Review

Phosphorylated vimentin-triggered fibronectin matrix disaggregation enhances the dissemination of Treponema pallidum subsp. pallidum across the microvascular endothelial barrier

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