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Treponema pallidum in leukoderma syphiliticum demonstrated by electron microscopy
A Poulsen1, L Secher, T Kobayasi
1Department of Dermatology, University of Copenhagen, Denmark.
Acta Dermato-Venereologica
|January 1, 1988
Summary
Syphilitic leukoderma may indicate active syphilis infection, not just a post-inflammatory effect. Treponema pallidum were found in nerve fibers of one patient with this pigment disorder.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Syphilitic leukoderma, a pigment disorder, is often considered a post-inflammatory consequence of secondary syphilis.
- The exact pathogenesis and relationship to active infection remain areas for investigation.
Observation:
- Punch biopsies from syphilitic leukoderma lesions and unaffected skin of three secondary syphilis patients were examined using transmission electron microscopy.
- Treponema pallidum were identified in leukodermal lesions of one patient, notably within nerve fibers showing myelin degeneration, even without preceding visible syphilids.
- No treponemes were detected in biopsies from the other two patients' leukodermal lesions or unaffected skin.
Findings:
- The presence of Treponema pallidum in active leukodermal lesions challenges the notion that it is solely a post-inflammatory phenomenon.
- Degeneration of myelin sheaths within nerve fibers suggests direct involvement of the pathogen in the observed pigmentary changes.
Implications:
- Syphilitic leukoderma may serve as a direct clinical stigmata of active syphilitic infection, not merely a residual effect.
- This finding necessitates a re-evaluation of diagnostic and treatment approaches for patients presenting with syphilitic leukoderma.