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A histopathological study of secondary syphilis
Author(s) -
McMillan A.,
McQueen A.,
McLaren C.
Publication year - 1996
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.1996.tb00576.x
Subject(s) - medicine , syphilis , rash , dermatology , etiology , biopsy , pathology , histology , differential diagnosis , human immunodeficiency virus (hiv) , immunology
Objectives To study the histology of the skin lesions of secondary syphilis. Background Secondary syphilis is becoming less prevalent in developed countries and clinicians not familiar with the condition may resort to biopsy to elucidate the nature of a rash. It is therefore important that Dermatopathologists are aware of the histological features of secondary syphilis. Design Patients with secondary syphilis, who attended clinics held by one of us during a 10 year period and who consented to biopsy, were studied. Subjects Twenty‐eight individuals. Methods Skin biopsies of representative lesions. Routine histological processing. Results The most common finding was that of an erythema multiforme pattern of papillary oedema and perivascular lympho‐histiocytic infiltration (19 cases including the 2 men with HIV infection). The tissue reaction was mild in patients with macular lesions. Focal lichenoid tissue reaction (4 cases), a pseudolymphomatous appearance (1 case), and granuloma formation (3 cases) were noted in other patients. The histology of a condyloma latum was typical. Conclusions Our study serves to emphasise the importance of clinicopathological correlation in the assessment of a skin rash and to remind pathologists of secondary syphilis as an aetiological factor in macular and papular skin lesions. The mimicry of several other conditions confounds the specificity of the changes and shows that syphilis is a theoretical candidate in considering the aetiology of the changes seen. Careful scrutiny of all the histopathological features may permit a relatively refined differential diagnosis to be established and, either prospectively or retrospectively, alert the clinician to the appropriate additional investigative techniques which will allow a sound diagnosis to be attained.