Syphilis

[Syphilis in surgery-Safe diagnosis and correct treatment]

BACKGROUND

The incidence of syphilis has clearly increased in Germany in recent years. This infectious disease has many forms of manifestation and can imitate surgical diseases.

MATERIAL AND METHODS

Comprehensive footage of experiences in a proctological center demonstrates these manifestations and explains the correct management.

RESULTS

The likelihood of confusion of syphilis with anal fissures, anogenital warts, proctitis and rectal cancer is high.

CONCLUSION

Surgeons can encounter syphilis, the "chameleon of medicine" and must know the differential diagnoses.

[New aspects in the histopathology of infectious skin diseases]

BACKGROUND

An infectious pathogenesis should always be considered in inflammatory infiltrates in the skin. While some organisms can be recognized on hematoxylin-eosin staining (e.g. yeasts, leishmania), histochemical and immunohistochemical stainings are available for others.

OBJECTIVES

If no organisms are seen in a section, the diagnosis of an infection cannot be made with surety, but the pattern of the inflammatory infiltrate can still be suggestive of an infectious process. New or little-known reaction patterns and difficulties in differential diagnosis will be demonstrated.

MATERIALS AND METHODS

Selective literature review and analysis of individual cases.

RESULTS

Studies using molecular techniques to identify organisms in biopsy specimens have helped to better characterize the histomorphological spectrum of skin infiltrates in infectious skin diseases. Apart from unusual herpes simplex and varicella zoster infections, the histopathology of coxsackie virus and measles exanthem, borreliosis, syphilis, and of cutaneous leishmaniasis is demonstrated. For numerous organisms, molecular tests have been established that can be used on the formalin-fixed, paraffin-embedded material.

CONCLUSIONS

Selected skin infections demonstrate the broad histomorphological spectrum of skin infiltrates induced by infectious organisms. It is important for histopathologists to know which reaction pattern requires them to alert the clinician to necessary ancillary diagnostics (culture, serology) and when to consider molecular diagnostics to be performed on the biopsy specimen.

[Clinical manifestations of syphilis in maxillofacial area. Part II]

The article presents a review of the literature with a description of typical manifestations in the maxillofacial area in secondary, tertiary period of syphilis and the description of photo-images of the authors' clinical observations. In the secondary period of syphilis rashes can be found both on the skin and mucous membranes. In secondary reccurent syphilis the oral cavity is affected in 56% of the cases. Typical manifestations of this period are: roseola, papular and pustular syphilides. In the mouth the most frequently observed manifestation is popular syphilide or erythematous sore throat. The syphilitic papule of the mucous membrane of the mouth is flat, sharply demarcated, gets frequently eroded due to maceration or trauma. This papule is highly contagious element. Pustular syphilides are found mostly on the face and are a manifestation of a malignant course of the disease. Tertiary syphilis is a rare form of infection, which is observed as destructive injuries of organs and systems. The most frequent localization of gummy syphilide is the head. This article is highly revalent due to the high frequency of infection manifestation in maxillo-facial area, oral mucosa, and the high contagiousness symptoms, also affecting children.