Detection of &lt;i&gt;Treponema pallidum&lt;/i&gt; in Skin Lesions of Secondary Syphilis and Characterization of the Inflammatory Infiltrate

Li, Wenhai; Zhang, Jianzhong; Cao, Ying

doi:10.1159/000076479

Cited by 43 publications

(38 citation statements)

References 3 publications

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“…Histological patterns of cutaneous syphilis have been characterized extensively, and, during the past decade, immunohistological techniques have identified the nature of inflammatory cells [24,25]. Nevertheless, compared with many other common inflammatory disorders, little is known about the local immune responses to T. pallidum in skin and other body sites [26,27,28].…”

Section: Discussionmentioning

confidence: 99%

Perivascular Cuff and Spread of <i>Treponema pallidum</i>

Quatresooz

Pierard

2009

Dermatology

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Background: The incidence of syphilis is on the rise in many cities worldwide. Both the clinical and histopathological changes do not always fulfil the typical diagnostic criteria. Immunohistochemistry is available to identify and localize Treponema pallidum. Two main patterns of T. pallidum distribution were described in the skin, namely heavy intraepidermal infiltration and scattered pattern inside the lichenoid cell infiltrate. Objective: To search for a third pattern consistent with dissemination of the disease. Methods: Immunohistochemistry using an antispirochete (T. pallidum and Borrelia) antibody was used in all cases of syphilis submitted to our laboratory. In addition, deposits of immunoglobulins and complement indicative of immune complexes were searched for. Results: According to the cases, T. pallidum was disclosed in a combination of three patterns. The previously described epidermal and lichenoid patterns were confirmed, and a third pattern predominating in a perivascular location throughout the dermis was clearly identified in primary syphilis. The microorganisms were abundant in extracellular and intracellular locations, particularly inside endothelial cells. No deposits of immunoglobulins and complement were disclosed. Conclusion: The perivascular cuff of T. pallidum throughout the dermis might be representative of the dissemination phase of T. pallidum.

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Section: Discussionmentioning

confidence: 99%

Perivascular Cuff and Spread of <i>Treponema pallidum</i>

Quatresooz

Pierard

2009

Dermatology

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“…Similarly, T cells and macrophages are found in rabbit dermal lesions (276), as well as in human primary chancres (90,314,325) and secondary lesions (90,198,325,333 (198). mRNA for the cytokines gamma interferon (IFN-␥) and IL-2, which function to activate macrophages and stimulate proliferation of T cells, respectively, is also found in primary and secondary lesions (323).…”

Section: Immune Clearancementioning

confidence: 99%

Biological Basis for Syphilis

2006

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SUMMARY Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum subsp. pallidum. Clinical manifestations separate the disease into stages; late stages of disease are now uncommon compared to the preantibiotic era. T. pallidum has an unusually small genome and lacks genes that encode many metabolic functions and classical virulence factors. The organism is extremely sensitive to environmental conditions and has not been continuously cultivated in vitro. Nonetheless, T. pallidum is highly infectious and survives for decades in the untreated host. Early syphilis lesions result from the host's immune response to the treponemes. Bacterial clearance and resolution of early lesions results from a delayed hypersensitivity response, although some organisms escape to cause persistent infection. One factor contributing to T. pallidum's chronicity is the paucity of integral outer membrane proteins, rendering intact organisms virtually invisible to the immune system. Antigenic variation of TprK, a putative surface-exposed protein, is likely to contribute to immune evasion. T. pallidum remains exquisitely sensitive to penicillin, but macrolide resistance has recently been identified in a number of geographic regions. The development of a syphilis vaccine, thus far elusive, would have a significant positive impact on global health.

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“…In molecular studies, T. pallidum DNA was detected in lesional follicles, providing further support for a specific immunological reaction to T. pallidum antigens [24]. A recent Chinese study demonstrated the presence of T. pallidum in mucocutaneous lesions of secondary syphilis using highly sensitive nested polymerase chain reaction [25]. If the papular syphilides are located in intertriginous areas, maceration can lead to flat, damp lesions, the so-called condylomata lata.…”

Section: Clinical Features Of Casesmentioning

confidence: 99%

Sexually Transmitted Infections in Switzerland: Return of the Classics

Lautenschlager

2005

Dermatology

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Recent trends in western Europe show an increase in sexually transmitted infections (STIs). Available surveillance data in Switzerland confirm this rising trend. Gonorrhoea rates more than doubled between 1996 and 2003, and for Chlamydia there was a 64% increase from 1999 to 2003. Notifications of syphilis cases almost doubled in the year 2002 and rose to 174% compared to the period of 1998–2001. The resurgence of syphilis in 2002 and 2003 was most important in Zurich and Geneva with 54 and 24% of all cases, respectively. Eighty-four percent occurred in males, 40% affecting males who had sex with males, and at least 17% were HIV co-infected. For 2004, further increases in these bacterial STIs are expected. Increased awareness of the symptoms and signs of acute infections is needed as well as considering the diagnosis of STIs in patients with vague symptoms. In addition, laboratory reporting or mandatory disease notifications are needed to monitor syphilis trends in Switzerland.

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Detection of <i>Treponema pallidum</i> in Skin Lesions of Secondary Syphilis and Characterization of the Inflammatory Infiltrate

Cited by 43 publications

References 3 publications

Perivascular Cuff and Spread of <i>Treponema pallidum</i>

Perivascular Cuff and Spread of <i>Treponema pallidum</i>

Biological Basis for Syphilis

Sexually Transmitted Infections in Switzerland: Return of the Classics

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