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Skin-nontumor
Infectious disorders
Syphilis

Reviewer: Mowafak Hamodat, M.D. (see Reviewers page)

Revised: 21 September 2014, last major update March 2011

Copyright: (c) 2003-2014, PathologyOutlines.com, Inc.

PubMed Search: Syphilis [title] skin

Clinical features
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• 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

Clinical description
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• Scaly, flesh-colored to erythematous papules or annular plaques
• Copper macules on palms and soles

Clinical images
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Secondary, courtesy of Dr. Mark R. Wick

Gumma, courtesy of Dr. Mark R. Wick

Micro description
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• 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

Micro images
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Primary syphilis

 

Secondary, breast skin, courtesy of Dr. Mark R. Wick

Steiner stain, secondary, courtesy of Dr. Mark R. Wick

Gumma, breast, courtesy of Dr. Mark R. Wick

Positive stains
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• Steiner stain (71% sensitive)

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