Ambrogio Francesca, Cazzato Gerardo, Foti Caterina, Grandolfo Mauro, Mennuni Gisella Biagina, Vena Gino Antonio, Cassano Nicoletta, Lettini Teresa, Castronovi Cosimo, Ingordo Vito, Romita Paolo, Filotico Raffaele
Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy.
Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy.
Pathogens. 2023 Aug 18;12(8):1054. doi: 10.3390/pathogens12081054.
The diagnosis of syphilis can be challenging for dermatologists and dermatopathologists. In particular, secondary syphilis can have different clinical and histopathological presentations. A granulomatous tissue response is an unusual finding in secondary syphilis. We report the case of a 77-year-old man who presented with a 4-week history of non-pruritic generalised macules, papules, nodules and plaques. Histopathologically, there was a dense perivascular and periadnexal lympho-histiocytic dermal infiltrate with non-palisading and non-caseifying epithelioid granulomas and abundant plasma cells. The diagnosis of syphilis was confirmed by serology and immunohistochemical detection of in the biopsy specimen. A brief overview of the diagnostic role of immunohistochemistry is also provided, with particular emphasis on reported cases of granulomatous secondary syphilis.
梅毒的诊断对于皮肤科医生和皮肤病理学家而言可能具有挑战性。特别是二期梅毒可能有不同的临床和组织病理学表现。肉芽肿性组织反应在二期梅毒中是不常见的表现。我们报告一例77岁男性患者，其有4周的非瘙痒性全身性斑疹、丘疹、结节和斑块病史。组织病理学检查显示，真皮血管周围和附件周围有密集的淋巴细胞 - 组织细胞浸润，伴有非栅栏状、非干酪样上皮样肉芽肿和大量浆细胞。活检标本的血清学和免疫组织化学检测证实了梅毒的诊断。本文还简要概述了免疫组织化学的诊断作用，特别强调了肉芽肿性二期梅毒的报告病例。
