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 © 2001-2009, DermAtlas | Image Name: | syphillis_1_061101 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, SECONDARY | Category: | infections and infestations | ||
| Body Site: | back | Age: | 54 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is a predominantly dermal infiltrate, extending deep into the biopsy in a vaguely perivascular pattern. The epidermis is only mildly acanthotic. | ||||
| Comments: | This is a somewhat unusual case of syphilis, as it is more granulomatous than the textbook example. Typically, one would see a psoriasiform hyperplasia with numerous plasma cells. The histiocytic component may represent a late secondary moving to tertiary (gummatous) phase. When there is a mixed pattern with plasma cells and granulomas, one must always think of syphilis. This disease is prevalent in Dallas, although usually presents in the STD clinic and is not biopsied. One can pick up the treponemes using a silver stain (Warthin-Starry or Steiner) or a immunohistochemical stain, as in this case. We happen to have a good immunohistochemical stain for t. pallidum. | ||||
| Related Images: | All related Images syphillis_3_061101 syphillis_2_061101 | ||||
 © 2001-2009, DermAtlas | Image Name: | syphillis_2_061101 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, SECONDARY | Category: | infections and infestations | ||
| Body Site: | back | Age: | 54 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The infiltrate consists of a mixture of lymphocytes, histiocytes with granuloma formation, and plasma cells. | ||||
| Comments: | This is a somewhat unusual case of syphilis, as it is more granulomatous than the textbook example. Typically, one would see a psoriasiform hyperplasia with numerous plasma cells. The histiocytic component may represent a late secondary moving to tertiary (gummatous) phase. When there is a mixed pattern with plasma cells and granulomas, one must always think of syphilis. This disease is prevalent in Dallas, although usually presents in the STD clinic and is not biopsied. One can pick up the treponemes using a silver stain (Warthin-Starry or Steiner) or a immunohistochemical stain, as in this case. We happen to have a good immunohistochemical stain for t. pallidum. | ||||
| Related Images: | All related Images syphillis_3_061101 syphillis_1_061101 | ||||
 © 2001-2009, DermAtlas | Image Name: | syphillis_3_061101 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, SECONDARY | Category: | infections and infestations | ||
| Body Site: | back | Age: | 54 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | Usuing an immunohistochemical staqin for t. pallidum, scattered spirochetal forms light up. One is present in the center of the field, within a granuloma. | ||||
| Comments: | This is a somewhat unusual case of syphilis, as it is more granulomatous than the textbook example. Typically, one would see a psoriasiform hyperplasia with numerous plasma cells. The histiocytic component may represent a late secondary moving to tertiary (gummatous) phase. When there is a mixed pattern with plasma cells and granulomas, one must always think of syphilis. This disease is prevalent in Dallas, although usually presents in the STD clinic and is not biopsied. One can pick up the treponemes using a silver stain (Warthin-Starry or Steiner) or a immunohistochemical stain, as in this case. We happen to have a good immunohistochemical stain for t. pallidum. | ||||
| Related Images: | All related Images syphillis_2_061101 syphillis_1_061101 | ||||
 © 2001-2009, DermAtlas | Image Name: | syphilis_2_060823 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, SECONDARY | Category: | infections and infestations / papulosquamous eruptions | ||
| Body Site: | foot / sole | Age: | 25 years | ||
| Contributor: | Shahbaz A. Janjua, MD | ||||
| Description: | erythematous indurated ulcerated plaque with superficial crusting | ||||
| Comments: | This 25-year-old sexually active boy had an asymptomatic round indurated crusted erosion on the pubic area associated with painless inguinal lymphadenopathy for two months. He subsequently developed a generalized pruritic red scaly eruption most prominent on the palms and soles. | ||||
| Related Images: | All related Images syphilis_1_060823 syphilis_3_060823 syphilis_4_060823 syphilis_5_060823 | ||||
 © 2001-2009, DermAtlas | Image Name: | syphilis_1_060823 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, SECONDARY | Category: | infections and infestations / papulosquamous eruptions | ||
| Body Site: | foot / sole | Age: | 25 years | ||
| Contributor: | Shahbaz A. Janjua, MD | ||||
| Description: | red scaly 0.5-1.0 cm papules with dusky centers | ||||
| Comments: | This 25-year-old sexually active boy had an asymptomatic round indurated crusted erosion on the pubic area associated with painless inguinal lymphadenopathy for two months. He subsequently developed a generalized pruritic red scaly eruption most prominent on the palms and soles. | ||||
| Related Images: | All related Images syphilis_2_060823 syphilis_3_060823 syphilis_4_060823 syphilis_5_060823 | ||||
 © 2001-2009, DermAtlas | Image Name: | Syphilis_1_050829 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, PRIMARY / SYPHILIS, SECONDARY / HUMAN IMMUNODEFICIENCY VIRUS INFECTION | Category: | infections and infestations / sexually transmitted disease | ||
| Body Site: | penis / neck sole | Age: | 19 years | ||
| Contributor: | Amit Kalra, MD | ||||
| Description: | ulcerated indurated plaque on the penile shaft and warty papules on the scrotum | ||||
| Comments: | This adolescent was evaluated for a red indurated ulcerated plaque on the mid penile shaft following a week of painless inguinal adenopathy. Three weeks later he developed a widespread papulosquamous eruption on the trunka and extremities including the palms and soles. Condylomata lata lesions were noted on the scrotum. His serological tests for syphilis and HIV test were positive, and histopathology of the ulcer was consistent with a primary syphilitic chancre. | ||||
| Related Images: | All related Images Syphilis_6_050829 Syphilis_5_050829 Syphilis_4_050829 Syphilis_3_050829 Syphilis_2_050829 | ||||
 © 2001-2009, DermAtlas | Image Name: | Syphilis_2_050829 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, PRIMARY / SYPHILIS, SECONDARY / HUMAN IMMUNODEFICIENCY VIRUS INFECTION | Category: | infections and infestations / sexually transmitted disease | ||
| Body Site: | scrotum | Age: | 19 years | ||
| Contributor: | Amit Kalra, MD | ||||
| Description: | warty papules | ||||
| Comments: | This adolescent was evaluated for a red indurated ulcerated plaque on the mid penile shaft following a week of painless inguinal adenopathy. Three weeks later he developed a widespread papulosquamous eruption on the trunka and extremities including the palms and soles. Condylomata lata lesions were noted on the scrotum. His serological tests for syphilis and HIV test were positive, and histopathology of the ulcer was consistent with a primary syphilitic chancre. | ||||
| Related Images: | All related Images Syphilis_6_050829 Syphilis_5_050829 Syphilis_4_050829 Syphilis_3_050829 Syphilis_1_050829 | ||||
 © 2001-2009, DermAtlas | Image Name: | Syphilis_3_050829 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, PRIMARY / SYPHILIS, SECONDARY / HUMAN IMMUNODEFICIENCY VIRUS INFECTION | Category: | infections and infestations / sexually transmitted disease | ||
| Body Site: | mouth / palate, hard | Age: | 19 years | ||
| Contributor: | Amit Kalra, MD | ||||
| Description: | red papules and patches | ||||
| Comments: | This adolescent was evaluated for a red indurated ulcerated plaque on the mid penile shaft following a week of painless inguinal adenopathy. Three weeks later he developed a widespread papulosquamous eruption on the trunka and extremities including the palms and soles. Condylomata lata lesions were noted on the scrotum. His serological tests for syphilis and HIV test were positive, and histopathology of the ulcer was consistent with a primary syphilitic chancre. | ||||
| Related Images: | All related Images Syphilis_6_050829 Syphilis_5_050829 Syphilis_4_050829 Syphilis_2_050829 Syphilis_1_050829 | ||||
 © 2001-2009, DermAtlas | Image Name: | Syphilis_4_050829 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, PRIMARY / SYPHILIS, SECONDARY / HUMAN IMMUNODEFICIENCY VIRUS INFECTION | Category: | infections and infestations / sexually transmitted disease | ||
| Body Site: | penis | Age: | 19 years | ||
| Contributor: | Amit Kalra, MD | ||||
| Description: | ulcerated indurated plaque on the penile shaft and warty papules on the scrotum | ||||
| Comments: | This adolescent was evaluated for a red indurated ulcerated plaque on the mid penile shaft following a week of painless inguinal adenopathy. Three weeks later he developed a widespread papulosquamous eruption on the trunka and extremities including the palms and soles. Condylomata lata lesions were noted on the scrotum. His serological tests for syphilis and HIV test were positive, and histopathology of the ulcer was consistent with a primary syphilitic chancre. | ||||
| Related Images: | All related Images Syphilis_6_050829 Syphilis_5_050829 Syphilis_3_050829 Syphilis_2_050829 Syphilis_1_050829 | ||||
 © 2001-2009, DermAtlas | Image Name: | Syphilis_5_050829 | File Type: | jpg | |
| Diagnosis: | SYPHILIS, PRIMARY / SYPHILIS, SECONDARY / HUMAN IMMUNODEFICIENCY VIRUS INFECTION | Category: | infections and infestations / sexually transmitted disease | ||
| Body Site: | neck | Age: | 19 years | ||
| Contributor: | Amit Kalra, MD | ||||
| Description: | symmetric minimally scaly hypooigmented papules | ||||
| Comments: | This adolescent was evaluated for a red indurated ulcerated plaque on the mid penile shaft following a week of painless inguinal adenopathy. Three weeks later he developed a widespread papulosquamous eruption on the trunka and extremities including the palms and soles. Condylomata lata lesions were noted on the scrotum. His serological tests for syphilis and HIV test were positive, and histopathology of the ulcer was consistent with a primary syphilitic chancre. | ||||
| Related Images: | All related Images Syphilis_6_050829 Syphilis_4_050829 Syphilis_3_050829 Syphilis_2_050829 Syphilis_1_050829 | ||||
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