The Experts below are selected from a list of 3873 Experts worldwide ranked by ideXlab platform
Sanghoon Lee - One of the best experts on this subject based on the ideXlab platform.
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bone involvement in Secondary Syphilis a case report and systematic review of the literature
Sexually Transmitted Diseases, 2014Co-Authors: Kiho Park, Mi Suk Lee, Il Ki Hong, Jiyoun Sung, Sangho Choi, Sang Ok Park, Myung Jin Shin, Hyewon Chung, Sanghoon LeeAbstract:AbstractBone involvement is an unusual manifestation of Secondary Syphilis, but little information is available in the English-language literature. We carried out a systematic review of the English-language literature from 1964 to 2013, describing cases of Secondary Syphilis with bone involvement. W
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bone involvement in Secondary Syphilis a case report and systematic review of the literature
Sexually Transmitted Diseases, 2014Co-Authors: Kiho Park, Mi Suk Lee, Il Ki Hong, Jiyoun Sung, Sangho Choi, Sang Ok Park, Myung Jin Shin, Hyewon Chung, Sanghoon LeeAbstract:Bone involvement is an unusual manifestation of Secondary Syphilis, but little information is available in the English-language literature. We carried out a systematic review of the English-language literature from 1964 to 2013, describing cases of Secondary Syphilis with bone involvement. We also describe a case of Secondary Syphilis with multiple osteolytic lesions, mimicking metastatic cancer or myeloma, which was included in an analysis of 37 eligible cases of Secondary Syphilis with bone involvement. Of these 37 patients, 28 (76%) patients were male, and the median age was 32 years (range, 12-64 years). Eleven (30%) patients had human immunodeficiency virus (HIV) infection with a median CD4 lymphocyte count of 343 cells/mm (range, 130-689 cells/mm). The diagnosis of early Syphilis was suspected based on mucocutaneous findings in 28 (76%) cases. In the remaining 9 (24%) cases, high titers of nontreponemal serologic tests were the only evidence of early Syphilis. The median venereal disease research laboratory (VDRL) titer was 1:64 (range, 1:8-1:320), and median rapid plasma reagin (RPR) titer was 1:64 (range, 1:16-1:512). The bones most often affected were long bones of the limbs (n = 22) and skull (n = 21). The bone lesions were multifocal in 27 (73%) cases and osteolytic in 19 (51%) cases. The treatment of syphilitic bone lesions was medical only in most patients, and prognosis was favorable with high-dose penicillin therapy. Clinical features and outcome between HIV-uninfected and HIV-infected patients were not different. Knowledge of this rare entity may lead to early diagnosis and appropriate management.
Tadashi Yoshino - One of the best experts on this subject based on the ideXlab platform.
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human immunodeficiency virus positive Secondary Syphilis mimicking cutaneous t cell lymphoma
Diagnostic Pathology, 2015Co-Authors: Michiko Yamashita, Yoshiyuki Fujii, Keiji Ozaki, Yoshio Urano, Masami Iwasa, Shingen Nakamura, Shiro Fujii, Masahiro Abe, Yasuharu Sato, Tadashi YoshinoAbstract:Malignant Syphilis or lues maligna is a severe form of Secondary Syphilis that was commonly reported in the pre-antibiotic era, and has now reemerged with the advent of the human immunodeficiency virus (HIV) epidemic. However, the characteristic histopathological findings of malignant Syphilis remain controversial. The aim of this case report was to clarify the clinical and histopathological findings of HIV-positive malignant Secondary Syphilis. A Japanese man in his forties complained of fever, skin lesions, headache, and myalgia without lymphadenopathy during the previous 4 weeks. The skin lesions manifested as erythematous, nonhealing, ulcerated papules scattered on his trunk, extremities, palm, and face. Although the skin lesions were suspected to be cutaneous T-cell lymphomas on histological analyses, they lacked T-cell receptor Jγ rearrangement; moreover, immunohistochemical analyses confirmed the presence of spirochetes. The patient was administered antibiotics and anti-retroviral therapy, which dramatically improved the symptoms. On the basis of these observations of the skin lesions, we finally diagnosed the patient with HIV-associated Secondary Syphilis that mimicked cutaneous T-cell lymphoma. The patient’s systemic CD4+ lymphocyte count was very low, and the infiltrate was almost exclusively composed of CD8+ atypical lymphocytes; therefore, the condition was easily misdiagnosed as cutaneous lymphoma. Although the abundance of plasma cells is a good indicator of malignant Syphilis on skin histological analyses, in some cases, the plasma cell count may be very low. Therefore, a diagnosis of malignant Secondary Syphilis should be considered before making a diagnosis of primary cutaneous peripheral T-cell lymphoma or lymphoma associated with HIV infection.
Kiho Park - One of the best experts on this subject based on the ideXlab platform.
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bone involvement in Secondary Syphilis a case report and systematic review of the literature
Sexually Transmitted Diseases, 2014Co-Authors: Kiho Park, Mi Suk Lee, Il Ki Hong, Jiyoun Sung, Sangho Choi, Sang Ok Park, Myung Jin Shin, Hyewon Chung, Sanghoon LeeAbstract:AbstractBone involvement is an unusual manifestation of Secondary Syphilis, but little information is available in the English-language literature. We carried out a systematic review of the English-language literature from 1964 to 2013, describing cases of Secondary Syphilis with bone involvement. W
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bone involvement in Secondary Syphilis a case report and systematic review of the literature
Sexually Transmitted Diseases, 2014Co-Authors: Kiho Park, Mi Suk Lee, Il Ki Hong, Jiyoun Sung, Sangho Choi, Sang Ok Park, Myung Jin Shin, Hyewon Chung, Sanghoon LeeAbstract:Bone involvement is an unusual manifestation of Secondary Syphilis, but little information is available in the English-language literature. We carried out a systematic review of the English-language literature from 1964 to 2013, describing cases of Secondary Syphilis with bone involvement. We also describe a case of Secondary Syphilis with multiple osteolytic lesions, mimicking metastatic cancer or myeloma, which was included in an analysis of 37 eligible cases of Secondary Syphilis with bone involvement. Of these 37 patients, 28 (76%) patients were male, and the median age was 32 years (range, 12-64 years). Eleven (30%) patients had human immunodeficiency virus (HIV) infection with a median CD4 lymphocyte count of 343 cells/mm (range, 130-689 cells/mm). The diagnosis of early Syphilis was suspected based on mucocutaneous findings in 28 (76%) cases. In the remaining 9 (24%) cases, high titers of nontreponemal serologic tests were the only evidence of early Syphilis. The median venereal disease research laboratory (VDRL) titer was 1:64 (range, 1:8-1:320), and median rapid plasma reagin (RPR) titer was 1:64 (range, 1:16-1:512). The bones most often affected were long bones of the limbs (n = 22) and skull (n = 21). The bone lesions were multifocal in 27 (73%) cases and osteolytic in 19 (51%) cases. The treatment of syphilitic bone lesions was medical only in most patients, and prognosis was favorable with high-dose penicillin therapy. Clinical features and outcome between HIV-uninfected and HIV-infected patients were not different. Knowledge of this rare entity may lead to early diagnosis and appropriate management.
Dirk M Elston - One of the best experts on this subject based on the ideXlab platform.
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histopathologic features distinguishing Secondary Syphilis from its mimickers
Journal of The American Academy of Dermatology, 2020Co-Authors: Alexandra Flamm, Viktoryia Kazlouskaya, Eun Ji Kwon, Veronica Merelo Alcocer, Dirk M ElstonAbstract:Background Syphilis is often misdiagnosed clinically, and biopsies might be required. Objective To determine histopathologic features that distinguish Secondary Syphilis from pityriasis lichenoides (PL), pityriasis rosea (PR), and early mycosis fungoides (MF). Methods Histopathologic features of 100 cases of Syphilis, 110 cases of PL, 72 cases of PR, and 101 cases of MF were compared. Results Elongated rete ridges and interstitial inflammation favor Syphilis over PL (likelihood ratios 3.44 and 2.72, respectively), but no feature reliably distinguishes between them. Secondary Syphilis and PR can be distinguished by neutrophils in the stratum corneum, plasma cells, interface dermatitis with lymphocytes and vacuoles, and lymphocytes with ample cytoplasm. Plasma cells and lymphocytes with ample cytoplasm are rare in early MF and can be used as distinguishing features. Conclusions Histopathologic features characteristic of Syphilis can be seen in PL, PR, and early MF. Distinguishing Syphilis from PL can be difficult histologically, and a high index of suspicion is required. Although elongation of rete and interstitial inflammation favor Syphilis, plasma cells (historically considered a significant feature of Syphilis) are often encountered in PL. Vacuolar interface dermatitis with a lymphocyte in every vacuole is considered characteristic of PL, but this feature appears to be more common in Syphilis.
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histologic features of Secondary Syphilis a multicenter retrospective review
Journal of The American Academy of Dermatology, 2015Co-Authors: Alexandra Flamm, Kruti Parikh, Qiang Xie, Eun Ji Kwon, Dirk M ElstonAbstract:Background Secondary Syphilis has a wide spectrum of clinical and histologic manifestations. Objective We sought to determine the frequency of histopathological features characterizing Secondary Syphilis, and which are most common in specimens displaying few diagnostic findings. Methods In a multicenter, retrospective analysis of biopsy-proven Secondary Syphilis, cases were subcategorized by the number of histologic characteristics present. Results The 106 cases mostly had 5 to 7 of the features studied. Many features were scarcer in cases with 5 or fewer features, including endothelial swelling (87.7% overall vs 72.4% ≤5 features), plasma cells (69.8% vs 48.3%), and elongated rete ridges (75.5% vs 27.6%). Specimens with 5 or fewer features were more likely to be truncal (61.1% vs 34.4% overall), demonstrate rete ridge effacement (44.8% vs 19.8%), and have pityriasis rosea (33.3% vs 17.2%) or drug eruption (33.3% vs 10.9%) in the clinical differential. An interstitial inflammatory pattern was the most common characteristic of specimens with 5 or fewer features (75.9%). Limitations This was a retrospective review. Conclusion The independent value of many histologic features of Syphilis may be overestimated. Combinations of endothelial swelling, interstitial inflammation, irregular acanthosis, and elongated rete ridges should raise the possibility of Syphilis, along with the presence of vacuolar interface dermatitis with a lymphocyte in nearly every vacuole and lymphocytes with visible cytoplasm.
Michiko Yamashita - One of the best experts on this subject based on the ideXlab platform.
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human immunodeficiency virus positive Secondary Syphilis mimicking cutaneous t cell lymphoma
Diagnostic Pathology, 2015Co-Authors: Michiko Yamashita, Yoshiyuki Fujii, Keiji Ozaki, Yoshio Urano, Masami Iwasa, Shingen Nakamura, Shiro Fujii, Masahiro Abe, Yasuharu Sato, Tadashi YoshinoAbstract:Malignant Syphilis or lues maligna is a severe form of Secondary Syphilis that was commonly reported in the pre-antibiotic era, and has now reemerged with the advent of the human immunodeficiency virus (HIV) epidemic. However, the characteristic histopathological findings of malignant Syphilis remain controversial. The aim of this case report was to clarify the clinical and histopathological findings of HIV-positive malignant Secondary Syphilis. A Japanese man in his forties complained of fever, skin lesions, headache, and myalgia without lymphadenopathy during the previous 4 weeks. The skin lesions manifested as erythematous, nonhealing, ulcerated papules scattered on his trunk, extremities, palm, and face. Although the skin lesions were suspected to be cutaneous T-cell lymphomas on histological analyses, they lacked T-cell receptor Jγ rearrangement; moreover, immunohistochemical analyses confirmed the presence of spirochetes. The patient was administered antibiotics and anti-retroviral therapy, which dramatically improved the symptoms. On the basis of these observations of the skin lesions, we finally diagnosed the patient with HIV-associated Secondary Syphilis that mimicked cutaneous T-cell lymphoma. The patient’s systemic CD4+ lymphocyte count was very low, and the infiltrate was almost exclusively composed of CD8+ atypical lymphocytes; therefore, the condition was easily misdiagnosed as cutaneous lymphoma. Although the abundance of plasma cells is a good indicator of malignant Syphilis on skin histological analyses, in some cases, the plasma cell count may be very low. Therefore, a diagnosis of malignant Secondary Syphilis should be considered before making a diagnosis of primary cutaneous peripheral T-cell lymphoma or lymphoma associated with HIV infection.