A pemphigus-like presentation of secondary syphilis

Kopelman, Hannah; Lin, Ann; Jorizzo, Joseph L.

doi:10.1016/j.jdcr.2019.07.021

Cited by 8 publications

(9 citation statements)

References 7 publications

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“…Syphilis testing should be offered to anyone presenting with a new papulosquamous rash or exanthem. Increasingly, nonpapulosquamous morphologies, including pustular, crusted or ecthymalike (so-called lues maligna), prurigo nodulelike, or targetoid morphologies, have been reported . Dermatologists should also be aware that ocular and neurosyphilis may present concurrently with PS syphilis.…”

Section: Clinical Characteristicsmentioning

confidence: 99%

Resurgence of Syphilis in the US—USPSTF Reaffirms Screening Guidelines

2022

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Since its modern-day nadir of 5979 cases per year, or 2.1 cases per 100 000 population, in 2001, primary and secondary (PS) syphilis incidence has rapidly increased. In 2019, 38 992 cases, or 11.9 cases per 100 000, were reported, more than a 5-fold increase. 1 The United States Preventive Services Task Force (USPSTF) currently "recommends screening for syphilis infection in persons who are at increased risk for infection (A recommendation)." 2 The recommendation applies to asymptomatic, nonpregnant adolescents and adults who have ever been sexually active and is based on findings that the benefits of screening outweigh the harms. Because dermatologists are among the frontline health care professionals in the fight against syphilis, the USPSTF recommendation, supported by an updated evidence report and systematic review, 3 presents an opportunity to update the dermatology community regarding recent trends in syphilis epidemiology, clinical presentation, testing, and treatment.

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Section: Clinical Characteristicsmentioning

confidence: 99%

Resurgence of Syphilis in the US—USPSTF Reaffirms Screening Guidelines

2022

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“…There have been other reports of secondary syphilis mimicking pemphigus clinically 4 , 5 but, to our knowledge, this is the first case of secondary syphilis with positive DIF results for pemphigus vulgaris. Additionally, it is rare for syphilis to present with acantholysis, limited to few case reports in the literature.…”

Section: Discussionmentioning

confidence: 58%

A case of secondary syphilis presenting like pemphigus with positive direct immunofluorescence

Stone,

Nicholson,

Florell

et al. 2023

JAAD Case Reports

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“…In study by Kopelman et al . [ 29 ] the researchers showed that the skin lesions and dermatopathological analysis showed a pemphigus-like presentation of secondary syphilis. However, other related methods can help pathological studies to make a powerful decision in these patients, for example Müller et al .…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic assessment of secondary syphilis avoids misdiagnosis: results of comprehensive evaluation of 114 cases

Zhao,

Luo,

et al. 2024

pdia

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Introduction Secondary syphilis is well-known for its protean cutaneous manifestations and therefore very easy to be misdiagnosed. Aim The current study was to observe the frequency of histopathological features characterizing secondary syphilis, and summarize the diseases most likely to be misdiagnosed. Material and methods In this study a total of 129 pathological specimens from 114 patients with biopsy-proven secondary syphilis were retrospectively analysed and categorized according to clinicopathologic characteristics. The frequency of histopathological features characterizing secondary syphilis were analysed by comparison with clinical features. Results We found that in a single sample there is at least one feature or at most 13 features exist concurrently, and most demonstrated between 5 and 9 diagnostic features. Plasma cells (97.6% overall vs. 94.0% ≤ 6 features), endothelial swelling (86.8% vs. 74.0%), epidermis hyperplasia (73.6% vs. 62.0%) especially irregular acanthosis, lymphocytes infiltration (71.3% vs. 52.0%) and interstitial patterns (69% vs. 72.0%) were the most common findings in all cases as well as in cases with ≤ 6 features. Granulomatous inflammation is an uncommon histopathologic pattern in secondary syphilis (12.4%). The rash morphologies of our biopsies mainly manifesting as macules and maculopapules were more likely to have 6 or fewer features, which were not only easily misdiagnosed for pityriasis rosea, tinea and erythema multiforme, but also mostly taken from the trunk and genitalia. Atypical morphologies can be combined with plasma cell infiltration and T. pallidum immunohistochemical stain to confirm the diagnosis. Conclusions In this study plasma cells from superficial and deep perivascular distribution to nodular infiltration were a crucial clue for diagnosis of secondary syphilis.

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A pemphigus-like presentation of secondary syphilis

Cited by 8 publications

References 7 publications

Resurgence of Syphilis in the US—USPSTF Reaffirms Screening Guidelines

Resurgence of Syphilis in the US—USPSTF Reaffirms Screening Guidelines

A case of secondary syphilis presenting like pemphigus with positive direct immunofluorescence

Clinicopathologic assessment of secondary syphilis avoids misdiagnosis: results of comprehensive evaluation of 114 cases

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