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Related Experiment Videos

Primary and secondary syphilis: a histopathological study.

H J Engelkens1, F J ten Kate, V D Vuzevski

  • 1Department of Dermatology and Venereology, Erasmus University Rotterdam, The Netherlands.

International Journal of STD & AIDS
|July 1, 1991
PubMed
Summary

Histopathological examination of syphilis skin lesions revealed distinct treponemal presence and inflammatory patterns. While treponemes were consistently found in primary syphilis, differentiation from yaws can be challenging due to overlapping features.

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Area of Science:

  • Dermatopathology
  • Infectious Diseases
  • Microbiology

Background:

  • Syphilis, a sexually transmitted infection caused by Treponema pallidum, presents diverse clinical and histopathological manifestations.
  • Distinguishing between syphilis and other treponemal infections like yaws based solely on histology can be difficult.
  • Understanding the histopathological features of early syphilis is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the histopathological characteristics of skin lesions in patients with primary and secondary syphilis.
  • To identify key features that differentiate syphilitic lesions from those of yaws.
  • To determine the distribution and prevalence of Treponema pallidum in early syphilis lesions.

Main Methods:

  • Histopathological examination of skin biopsy specimens from 44 patients with primary or secondary syphilis.

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  • Utilized Steiner staining for the demonstration of treponemes.
  • Compared histopathological findings with known features of yaws lesions.

    • Main Results:

    • Primary syphilis lesions showed erosion or ulceration with dense inflammatory infiltrates.
    • Secondary syphilis exhibited varied histological changes, frequently involving blood vessels with endothelial swelling and proliferation.
    • Treponemes were detected in all primary syphilis cases and 71% of secondary syphilis cases, primarily in the dermis and dermal-epidermal junction, with some epidermal presence noted in specific secondary cases.
    • Plasma cells and lymphocytes were present in all specimens.
    • Syphilitic lesions differed from yaws by the dermal location of treponemes and more pronounced blood vessel involvement.

    Conclusions:

    • Histopathology reveals characteristic inflammatory patterns and treponemal distribution in early syphilis.
    • Blood vessel involvement and treponemal location in the dermis are key differentiating features from yaws.
    • Despite distinct features, histological differentiation between syphilis and yaws may not always be definitive due to overlapping manifestations.