PDF(Pubmed)
Abstract：
UNASSIGNED: Secondary syphilis is well-known for its protean cutaneous manifestations and therefore very easy to be misdiagnosed.
UNASSIGNED: The current study was to observe the frequency of histopathological features characterizing secondary syphilis, and summarize the diseases most likely to be misdiagnosed.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: In this study plasma cells from superficial and deep perivascular distribution to nodular infiltration were a crucial clue for diagnosis of secondary syphilis.
UNASSIGNED: The current study was to observe the frequency of histopathological features characterizing secondary syphilis, and summarize the diseases most likely to be misdiagnosed.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: In this study plasma cells from superficial and deep perivascular distribution to nodular infiltration were a crucial clue for diagnosis of secondary syphilis.
摘要：
■二期梅毒以其蛋白质的皮肤表现而闻名，因此很容易被误诊。
■当前的研究是观察表征继发性梅毒的组织病理学特征的频率，总结最容易误诊的疾病。
■在这项研究中，对114例经活检证实的二期梅毒患者的129个病理标本进行了回顾性分析，并根据临床病理特征进行了分类。通过与临床特征的比较，分析了表征继发性梅毒的组织病理学特征的频率。
■我们发现在单个样本中至少有一个特征或最多有13个特征同时存在，最多显示5至9个诊断特征。浆细胞（总体上为97.6％94.0%≤6个特征)，内皮肿胀（86.8%vs.74.0%），表皮增生（73.6%vs.62.0%)特别是不规则棘皮，淋巴细胞浸润（71.3%vs.52.0%）和间质模式（69%与72.0％）是所有病例以及≤6个特征的病例中最常见的发现。肉芽肿性炎症是继发性梅毒中罕见的组织病理学模式（12.4％）。我们的活检的皮疹形态主要表现为黄斑和斑丘疹更可能有6个或更少的特征，不仅容易误诊为玫瑰糠疹，癣和多形性红斑，但也大多取自躯干和生殖器。非典型形态可结合浆细胞浸润和梅毒螺旋体免疫组织化学染色确认诊断。
■在这项研究中，浆细胞从浅表和深层血管周围分布到结节浸润是诊断继发性梅毒的重要线索。
■当前的研究是观察表征继发性梅毒的组织病理学特征的频率，总结最容易误诊的疾病。
■在这项研究中，对114例经活检证实的二期梅毒患者的129个病理标本进行了回顾性分析，并根据临床病理特征进行了分类。通过与临床特征的比较，分析了表征继发性梅毒的组织病理学特征的频率。
■我们发现在单个样本中至少有一个特征或最多有13个特征同时存在，最多显示5至9个诊断特征。浆细胞（总体上为97.6％94.0%≤6个特征)，内皮肿胀（86.8%vs.74.0%），表皮增生（73.6%vs.62.0%)特别是不规则棘皮，淋巴细胞浸润（71.3%vs.52.0%）和间质模式（69%与72.0％）是所有病例以及≤6个特征的病例中最常见的发现。肉芽肿性炎症是继发性梅毒中罕见的组织病理学模式（12.4％）。我们的活检的皮疹形态主要表现为黄斑和斑丘疹更可能有6个或更少的特征，不仅容易误诊为玫瑰糠疹，癣和多形性红斑，但也大多取自躯干和生殖器。非典型形态可结合浆细胞浸润和梅毒螺旋体免疫组织化学染色确认诊断。
■在这项研究中，浆细胞从浅表和深层血管周围分布到结节浸润是诊断继发性梅毒的重要线索。
