title: [The role of reflectance confocal microscopy in the diagnosis of secondary syphilis of the vulva and anus: A first case report].
abstract: METHODS
  Herein we report the case of an 18-year-old pregnant patient presenting with plantar and ano-genital lesions of syphilis, pharyngitis, erythematosus and scalynasolabial intertrigo and angular cheilitis.
  In vivo reflectance confocal microscopy examination (Vivascope 3000®; Caliber Inc, Rochester, NY, USA, distributed in France by Mavig, Munich) of ano-genital lesions enabled us to identify hyper-reflective elongated rods in the papillary dermis suggesting spirochetes. The diagnosis was confirmed by TPHA and VDRL as well as immunohistological examination.
  
  
  CONCLUSIONS
  We identified for the first time rod shaped structures in ano-genital lesions of secondary syphilis, regularly alternating hyper-reflective and non-reflective areas corresponding to helix-shaped treponemes visualized by darkfield microscopy, which may not be confused with other cell structures.
authors: Service de dermatologie, hôpital universitaire de Saint-Etienne, 42055 Saint-Etienne cedex 2, France.
authors: A
authors: A
authors: Leclercq
authors: Service de dermatologie, hôpital universitaire de Saint-Etienne, 42055 Saint-Etienne cedex 2, France. Electronic address: elisacinotti@gmail.com.
authors: E
authors: E
authors: Cinotti
authors: Service de dermatologie, hôpital universitaire de Saint-Etienne, 42055 Saint-Etienne cedex 2, France.
authors: B
authors: B
authors: Labeille
authors: Service de dermatologie et laboratoire de dermatopathologie, hôpitaux universitaires de Strasbourg, 67091 Strasbourg cedex, France.
authors: B
authors: B
authors: Cribier
authors: Service de dermatologie, hôpital universitaire de Saint-Etienne, 42055 Saint-Etienne cedex 2, France.
authors: A C
authors: AC
authors: Biron
authors: Service de gynécologie, hôpital universitaire de Saint-Etienne, 42055 Saint-Etienne cedex 2, France.
authors: C
authors: C
authors: Vermersch
authors: Service de gynécologie, hôpital universitaire de Saint-Etienne, 42055 Saint-Etienne cedex 2, France.
authors: J
authors: J
authors: Montlouis
authors: Service de dermatologie, hôpital universitaire de Saint-Etienne, 42055 Saint-Etienne cedex 2, France.
authors: F
authors: F
authors: Cambazard
authors: Service de dermatologie, hôpital universitaire de Saint-Etienne, 42055 Saint-Etienne cedex 2, France.
authors: J L
authors: JL
authors: Perrot
mesh_terms: D000293:Adolescent; D001004:Anus Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology*; D005260:Female; D006801:Humans; D018613:Microscopy, Confocal; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000000981:diagnostic imaging / Q000382:microbiology; D013587:Syphilis / Q000000981:diagnostic imaging*; D014845:Vulvar Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology*
keywords: Imagerie non invasive; In vivo; Microscopie confocale par réflectance; Non-invasive imaging; Reflectance confocal microscopy; Syphilis; Treponema pallidum