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The role of reflectance confocal microscopy in the diagnosis of secondary syphilis of the vulva and anus: A first case report. [Article in French]

Leclercq A, Cinotti E, Labeille B, Cribier B, Biron AC, Vermersch C, Montlouis J, Cambazard F, Perrot JL; groupe imagerie cutanée non invasive de la Société française de dermatologie.

ABSTRACT

PATIENTS AND METHODS: Herein we report the case of an 18-year-old pregnant patient presenting with plantar and ano-genital lesions of syphilis, pharyngitis, erythematosus and scalynasolabial intertrigo and angular cheilitis.

REFLECTANCE CONFOCAL MICROSCOPY: In vivo reflectance confocal microscopy examination (Vivascope 3000®; Caliber Inc, Rochester, NY, USA, distributed in France by Mavig, Munich) of ano-genital lesions enabled us to identify hyper-reflective elongated rods in the papillary dermis suggesting spirochetes. The diagnosis was confirmed by TPHA and VDRL as well as immunohistological examination.

COMMENTS: We identified for the first time rod shaped structures in ano-genital lesions of secondary syphilis, regularly alternating hyper-reflective and non-reflective areas corresponding to helix-shaped treponemes visualized by darkfield microscopy, which may not be confused with other cell structures.

Copyright © 2016 Elsevier Masson SAS. All rights reserved.

KEYWORDS: Imagerie non invasive; In vivo; Microscopie confocale par réflectance; Non-invasive imaging; Reflectance confocal microscopy; Syphilis; Treponema pallidum

PMID:27567281 DOI:10.1016/j.annder.2016.07.010

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