%0 Case Reports
%T Granulomatous Secondary Syphilis: A Case Report with a Brief Overview of the Diagnostic Role of Immunohistochemistry.
%A Ambrogio F
%A Cazzato G
%A Foti C
%A Grandolfo M
%A Mennuni GB
%A Vena GA
%A Cassano N
%A Lettini T
%A Castronovi C
%A Ingordo V
%A Romita P
%A Filotico R
%J Pathogens
%V 12
%N 8
%D 2023 Aug 18
%M 37624014
%F 4.531
%R 10.3390/pathogens12081054
%X The diagnosis of syphilis can be challenging for dermatologists and dermatopathologists. In particular, secondary syphilis can have different clinical and histopathological presentations. A granulomatous tissue response is an unusual finding in secondary syphilis. We report the case of a 77-year-old man who presented with a 4-week history of non-pruritic generalised macules, papules, nodules and plaques. Histopathologically, there was a dense perivascular and periadnexal lympho-histiocytic dermal infiltrate with non-palisading and non-caseifying epithelioid granulomas and abundant plasma cells. The diagnosis of syphilis was confirmed by serology and immunohistochemical detection of Treponema pallidum in the biopsy specimen. A brief overview of the diagnostic role of immunohistochemistry is also provided, with particular emphasis on reported cases of granulomatous secondary syphilis.