Buffet Marc, Grange Philippe A, Gerhardt Philippe, Carlotti Agnès, Calvez Vincent, Bianchi Anne, Dupin Nicolas
UPRES-EA1833 Laboratoire de Recherche en Dermatologie, Centre National de Référence Syphilis, Paris, France.
J Invest Dermatol. 2007 Oct;127(10):2345-50. doi: 10.1038/sj.jid.5700888. Epub 2007 Jun 7.
Epidemiological aspects of syphilis in Western countries have undergone a significant change with respect to the number of cases. Detection of Treponema pallidum is difficult, and the correct diagnosis of secondary syphilis can be critical. In this study, biopsy samples from skin lesions of 12 patients with secondary syphilis were used. Diagnosis of syphilis was based on clinical presentation, dark-field microscope analysis, and serological tests. Using a polyclonal antibody directed against T. pallidum, we show the presence of T. pallidum in 90% of the samples studied with the bacteria located in the epidermis and the upper dermis. The T. pallidum 47-kDa surface protein gene could be amplified by PCR in 75% of the skin lesions. When combining both techniques, T. pallidum was detected in 92% of the samples from patients with secondary syphilis but not in the control samples. Our work suggests that both immunohistochemistry and PCR could be useful for the diagnosis of secondary syphilis and may be helpful in some rare cases when serological assays failed to detect T. pallidum antibodies.
西方国家梅毒的流行病学情况在病例数量方面发生了显著变化。梅毒螺旋体的检测较为困难，而二期梅毒的正确诊断可能至关重要。在本研究中，使用了12例二期梅毒患者皮肤病变的活检样本。梅毒的诊断基于临床表现、暗视野显微镜分析和血清学检测。使用针对梅毒螺旋体的多克隆抗体，我们发现在90%的研究样本中存在梅毒螺旋体，细菌位于表皮和真皮上层。75%的皮肤病变中可通过PCR扩增梅毒螺旋体47 kDa表面蛋白基因。将两种技术结合使用时，在92%的二期梅毒患者样本中检测到了梅毒螺旋体，但在对照样本中未检测到。我们的工作表明，免疫组织化学和PCR都可用于二期梅毒的诊断，并且在血清学检测未能检测到梅毒螺旋体抗体的一些罕见病例中可能会有所帮助。
