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Histopathologic features distinguishing secondary syphilis from its mimickers.

区分二期梅毒及其模拟物的组织病理学特征。

  • 影响因子:2.93
  • DOI:10.1016/j.jaad.2019.07.011
  • 作者列表:"Flamm A","Alcocer VM","Kazlouskaya V","Kwon EJ","Elston D
  • 发表时间:2020-01-01
Abstract

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.

摘要

背景: 梅毒在临床上常被误诊,可能需要活检。 目的: 探讨二期梅毒与苔藓样糠疹 (PL) 、玫瑰糠疹 (PR) 、早期蕈样肉芽肿 (MF) 的组织病理学特征。 方法: 对 100 例梅毒、 110 例PL、 72 例PR和 101 例MF的组织病理学特征进行比较。 结果: 细长的rete脊和间质炎症比PL更有利于梅毒 (似然比分别为 3.44 和 2.72),但没有可靠的特征区分它们。二期梅毒和PR可通过角质层的中性粒细胞、浆细胞、有淋巴细胞和空泡的界面皮炎和胞浆充足的淋巴细胞来区分。细胞质充足的浆细胞和淋巴细胞在早期MF中很少见,可作为鉴别特征。 结论: PL、PR和早期MF均可见梅毒的组织病理学特征。从组织学上区分梅毒和PL可能很困难,需要高怀疑指数。虽然rete和间质炎症的延长有利于梅毒,但在PL中经常遇到浆细胞 (历史上被认为是梅毒的一个显著特征)。空泡界面皮炎与淋巴细胞在每个空泡被认为是特征的PL,但这一特征似乎是更常见的梅毒。

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影响因子:2.93
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影响因子:0.96
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DOI:10.1097/DAD.0000000000001459
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皮肤肿瘤方向

皮肤肿瘤是发生在皮肤的细胞增生性疾病,是一种常见病。发生于皮内或皮下组织的新生物,种类很多,临床上分良性肿瘤和恶性肿瘤。恶性肿瘤可以不断增殖,引起转移,威胁生命,称为皮肤癌。

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