Granulomatous Folliculotropic Secondary Syphilis: An Unusual Histopathological Clue.

IF 1.1 4区 医学 Q4 DERMATOLOGY American Journal of Dermatopathology Pub Date : 2024-08-14 DOI:10.1097/DAD.0000000000002821
Eva Sánchez-Martínez, Jörg Schaller
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Abstract

Abstract: Syphilis is a sexually transmitted disease that can present a wide variety of clinical and histopathological manifestations. We present the case of a 75-year-old patient with a persistent maculopapular rash on the trunk and extremities, in which the biopsy showed an exclusively perifollicular granulomatous infiltrate. In the immunohistochemical staining with anti-Treponema pallidum antibodies, spirochetes scattered within the perifollicular inflammatory infiltrate were identified. These findings together with the serological analysis allowed the diagnosis of secondary syphilis. Folliculotropic nonalopecic syphilis is rare, and the pathogenic mechanisms that cause this specific tropism are unknown. On the other hand, granulomatous inflammation is a pattern typically described in tertiary syphilis but also occasionally found in secondary syphilis. We present a case of secondary syphilis with the combination of both histopathological findings, an uncommon constellation for dermatopathologists to consider.

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肉芽肿性滤泡性继发性梅毒:一条不寻常的组织病理学线索
摘要:梅毒是一种性传播疾病,可出现多种临床和组织病理学表现。我们报告了一例 75 岁患者的病例,患者躯干和四肢出现持续性斑丘疹,活组织检查显示完全是滤泡周围肉芽肿浸润。在用抗苍白螺旋体抗体进行免疫组化染色时,发现螺旋体散布在滤泡周围炎症浸润区。这些结果结合血清学分析,可以诊断为继发性梅毒。毛囊性非秃发梅毒非常罕见,导致这种特殊性的致病机制尚不清楚。另一方面,肉芽肿性炎症是三期梅毒的典型症状,但偶尔也会在二期梅毒中发现。我们介绍了一例同时具有这两种组织病理学结果的继发性梅毒病例,对于皮肤病理学家来说,这种情况并不常见。
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来源期刊
CiteScore
1.80
自引率
9.10%
发文量
453
审稿时长
3 months
期刊介绍: The American Journal of Dermatopathology offers outstanding coverage of the latest diagnostic approaches and laboratory techniques, as well as insights into contemporary social, legal, and ethical concerns. Each issue features review articles on clinical, technical, and basic science advances and illuminating, detailed case reports. With the The American Journal of Dermatopathology you''ll be able to: -Incorporate step-by-step coverage of new or difficult-to-diagnose conditions from their earliest histopathologic signs to confirmatory immunohistochemical and molecular studies. -Apply the latest basic science findings and clinical approaches to your work right away. -Tap into the skills and expertise of your peers and colleagues the world over peer-reviewed original articles, "Extraordinary cases reports", coverage of practical guidelines, and graphic presentations. -Expand your horizons through the Journal''s idea-generating forum for debating controversial issues and learning from preeminent researchers and clinicians
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