Treponema pallidum distribution patterns in mucocutaneous lesions of primary and secondary syphilis: an immunohistochemical and ultrastructural study

Infectious Diseases and Infestations of the Vulva

“…In secondary syphilis, immunohistochemical stains will show an epitheliotropic pattern with abundant spirochetes in the lower portion of the epidermis [ 81 ]. Molecular detection of T. pallidum with PCR test is more sensitive [ 82 -84 ].…”

Folliculotropic non-alopecic secondary syphilis

“…Spirochetes have also been described at the dermoepidermal junction, the dermis, and perivascularly. 5 Although in alopecia syphilitica the organisms may involve the hair follicle, 6 the clinical presentation of our patient was non-alopecic. This clinicopathologic presentation of folliculotropic non-alopecic syphilis highlights the importance of performing biopsy with treponemal staining in all HIV-infected patients suspected of having syphilis clinically.…”

A new test for an old foe… spirochaete immunostaining in the diagnosis of syphilis

“…T pallidum can now be successfully localised with immunohistochemical techniques; the process involves using a purified IgG antibody to detect spirochaetes in formalin-fixed paraffin-embedded tissue. In the past, histological tests for syphilis have included Warthin-Starry or Steiner's silver staining for spirochaetes; however, immunohistochemistry shows greater sensitivity when compared with Warthin-Starry staining 1 2. In addition, the immunohistochemical pattern of T pallidum distribution may even permit the diagnostic differentiation of primary from secondary syphilis 1…”