PMC8275113_01
Clinical manifestations and H&E staining before diagnosis of syphilis. (A) Thinning hair on the vertex with scattered erythema and papules on the scalp; (B) numerous scattered erythema and papules on the face; (C) lots of hypertrophic plaques with white scales on the occipital scalp and neck; (D-F) scattered erythema and papules on the trunk (D and E) and extremities (F), some of the lesions showed necrosis and escharosis. Hyperpigmentation was presented.
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Pruritus, joint tenderness and hyperpigmentation were also present (Figure 1A-F).
H&E staining shows PLEVA-like features before diagnosis of syphilis. (A and B) H&E staining of an erythema of the neck (A, X 40; B, X 100); (C and D) H&E staining of an escharosis lesion of the back (C, X 40; D, X 100). PLEVA-like histopathologic features such as hyperkeratosis in the epidermis, mild acanthosis, elongated rete ridges, vacuolization of the basal layer with exocytosis of inflammatory cells, lymphohistiocytic infiltration around the vascular plexus and red blood cells (RBC) extravasation in the dermis were noticed in the H&E staining figures.
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H&E staining results showed PLEVA-like histological features such as hyperkeratosis in the epidermis, mild acanthosis, elongated rete ridges, vacuolization of the basal layer with exocytosis of inflammatory cells, lymphohistiocytic infiltration around the vascular plexus and red blood cells (RBC) extravasation in the dermis (Figure 2A-D).
Clinical manifestations after neurosyphilis therapy. Erythema and papules on the scalp (A), face (B), trunk (C and D) and extremities (E and F) were significantly improved after neurosyphilis therapy treatment.
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After completing the therapy, the neurological and skin manifestations of the patient were significantly improved (Figure 3A-F) and serum-TRUST titer declined to 1:64 at December 19, 2016 and to 1:32 two months later.