Nodular secondary syphilis with associated granulomatous inflammation: case report and literature review.
A 62-year-old male presented with a 10-day history of a diffuse, erythematous papular rash sparing the palms and soles. Histopathologic examination of a skin lesion showed loose non-caseating granulomas in a lymphoplasmacytic background. Scattered spirochetes were identified by Treponema pallidum immunohistochemistry, in keeping with a diagnosis of secondary syphilis. Granulomatous inflammation in secondary syphilis is uncommon. A review of the literature reveals that the majority of prior reported cases of granulomatous secondary syphilis share similar characteristics to this case; namely, a papular or nodular clinical presentation, sparing of the palms and soles, and collections of epithelioid histiocytes with associated lymphocytes and variable numbers of plasma cells.
Department of Pathology, University of Iowa, Iowa City, IA, USA.
Carolyn
C
Rysgaard
Erik
E
Alexander
Brian L
BL
Swick
D006801:Humans; D007249:Inflammation / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000382:microbiology / Q000473:pathology*; D013587:Syphilis / Q000382:microbiology / Q000473:pathology*; D013591:Syphilis, Cutaneous / Q000382:microbiology / Q000473:pathology*; D014210:Treponema pallidum
granulomatous; infection; nodular syphilis; secondary syphilis; syphilis