Skin inflammatory (nontumor)
Infectious disorders

Author: Mowafak Hamodat, M.D., MB.CH.B, MSc.

Revised: 2 July 2018, last major update March 2011

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Syphilis skin [title]

Page views in 2018: 3,622
Page views in 2019 to date: 1,065
Cite this page: Hamodat, M. Syphilis. website. Accessed March 22nd, 2019.
Clinical features
  • Secondary lesions occur on face and trunk; are maculopapular and resemble drug eruption, lichen planus and psoriasis
  • May present as moth-eaten alopecia on scalp, mucous patches on tongue
  • Diagnose by serology
  • Scaly, flesh-colored to erythematous papules or annular plaques
  • Copper macules on palms and soles
Clinical images

Images hosted on PathOut servers:

Contributed by Dr. Mark R. Wick



Microscopic (histologic) description
  • Dense perivascular or diffuse plasma cell infiltrate with marked endothelial swelling and proliferation in blood vessels
  • May have noncaseating granulomas, vacuolar interface change, acanthosis, spongiosis or lymphocyte exocytosis
Microscopic (histologic) images

Images hosted on PathOut servers:

Contributed by
Hillary Rose Elwood, M.D.

Dense plasma cell infiltrate

Spirochete immunostain

 Contributed by
 Dr. Mark R. Wick

Steiner stain, secondary

Images hosted on other servers:

Primary syphilis

Positive stains
  • Steiner stain (71% sensitive)
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