SECONDARY SYPHILIS - CLINICOPATHOLOGICAL REVIEW
SECONDARY SYPHILIS - CLINICOPATHOLOGICAL REVIEW
复制标题
DOI：
10.1111/j.1365-2133.1975.tb06476.x
复制
发表时间：
1975-01-01
影响因子：
10.3
通讯作者：
JONES, EW
中科院分区：
文献类型：
--
作者：
ABELL, E;MARKS, R;JONES, EW
从57例二期梅毒患者的活检中发现的组织学表现与皮疹的临床形态相关。组织学模式有相当大的变化，一些经典描述的变化被发现不存在或不明显的频率被强调。特别有趣的是，在近四分之一的活检中，浆细胞浸润要么没有，要么非常稀疏，血管损伤不到一半。血管的改变几乎完全局限于内皮细胞的肿胀。内皮细胞增生最为少见。表皮经常参与炎症过程。胞吐、海绵状病变、角化不全和棘层增生是最常见的变化。丘疹和丘疹-鳞状病变之间没有一致的组织学差异，但黄斑病变表现为更浅、更不强烈的真皮浸润以及更不严重的表皮受累。在晚期继发性病变中，浸润变成肉芽肿，但在其他方面，检查的持续时间不能与病理相关。讨论了苔藓样糠疹与其他炎性皮肤病的鉴别诊断，并强调了组织病理学在诊断二期梅毒中的价值。
The histological appearances found in biopsies from fifty‐seven patients with secondary syphilis have been correlated with the clinical morphology of the eruptions. Considerable variation of histological pattern was encountered, and the frequency with which some of the classically described changes were found to be absent or inconspicuous is stressed. Of particular interest were the findings that, in nearly one‐quarter of the biopsies, plasma cell infiltration was either absent or very sparse, and that vascular damage was seen in less than half. Where present, the vessel changes were almost entirely confined to swelling of the endothelial cells. Proliferation of the endothelial cells was most uncommon.The epidermis was very frequently involved in the inflammatory process. Exocytosis, spongiosis, parakeratosis, and acanthosis were the most frequent changes. No consistent histological difference between papular and papulo‐squamous lesions could be found but macular lesions demonstrated more superficial and less intense dermal infiltration as well as less severe epidermal involvement.In late secondary lesions, the infiltrate became granulomatous, but in other respects the duration of the exanthem could not be correlated with the pathology.The differential diagnosis from pityriasis lichenoides and other inflammatory dermatoses is discussed and the value of histopathology in the diagnosis of secondary syphilis is emphasized.