{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:37:43Z","timestamp":1789141063215,"version":"build-2803163510"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Historically, granulomatous inflammation has been described in association with tertiary syphilis. However, in recent years there have been increasing reports of granulomatous inflammation in patients with secondary syphilis. Here, we discuss two patients who presented with erythematous infiltrated papules and nodules and were eventually diagnosed with granulomatous secondary syphilis, with clearance of their rashes following treatment. We highlight important clues that can point clinicians and histopathologists toward a diagnosis of syphilis instead of differential diagnoses such as leprosy in reaction, cutaneous histiocytosis and lymphoma. Furthermore, after performing a literature review and from our own experiences, we wish to highlight that granulomatous syphilis is often palmoplantar-sparing and its presence may not necessarily be a feature of immunocompromised states, such as HIV infection. In this increasingly connected world, the recognition of an atypical presentation of an age-old disease in patients with different skin types must be underscored by close clinicopathological correlations.<\/jats:p>","DOI":"10.1093\/ced\/llae448","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T07:20:04Z","timestamp":1729581604000},"page":"412-415","source":"Crossref","is-referenced-by-count":4,"title":["Granulomatous secondary syphilis: two case reports and a literature review"],"prefix":"10.1093","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2894-4508","authenticated-orcid":false,"given":"Delwyn Z J","family":"Lim","sequence":"first","affiliation":[{"name":"National Skin Centre ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel H L","family":"Lim","sequence":"additional","affiliation":[{"name":"National Skin Centre ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding Yuan","family":"Wang","sequence":"additional","affiliation":[{"name":"National Skin Centre ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5440-6688","authenticated-orcid":false,"given":"Martin T W","family":"Chio","sequence":"additional","affiliation":[{"name":"National Skin Centre ,","place":["Singapore"]},{"name":"Saw Swee Hock School of Public Health, National University Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,23]]},"reference":[{"key":"2025012715570614100_llae448-B1","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1001\/jamadermatol.2022.3499","article-title":"Resurgence of syphilis in the US\u2013USPSTF reaffirms screening guidelines","volume":"158","author":"Amerson","year":"2022","journal-title":"JAMA Dermatol"},{"key":"2025012715570614100_llae448-B2","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1056\/NEJMra1901593","article-title":"The modern epidemic of syphilis","volume":"382","author":"Ghanem","year":"2020","journal-title":"N Engl J Med"},{"key":"2025012715570614100_llae448-B3","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S0190-9622(86)70173-4","article-title":"Granulomatous tertiary syphilis","volume":"15","author":"Tanabe","year":"1986","journal-title":"J Am Acad Dermatol"},{"key":"2025012715570614100_llae448-B4","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/cup.12293","article-title":"Nodular secondary syphilis with associated granulomatous inflammation: case report and literature review","volume":"41","author":"Rysgaard","year":"2014","journal-title":"J Cutan Pathol"},{"key":"2025012715570614100_llae448-B5","doi-asserted-by":"crossref","first-page":"16992","DOI":"10.3390\/ijerph192416992","article-title":"Challenges in the diagnosis of tertiary syphilis: case report with literature review","volume":"19","author":"Jankowska","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2025012715570614100_llae448-B6","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.3390\/pathogens12081054","article-title":"Granulomatous secondary syphilis: a case report with a brief overview of the diagnostic role of immunohistochemistry","volume":"12","author":"Ambrogio","year":"2023","journal-title":"Pathogens"},{"key":"2025012715570614100_llae448-B7","first-page":"176","article-title":"Active syphilis in HIV infection: a multicentre retrospective survey. The German AIDS Study Group (GASG)","volume":"72","author":"Schofer","year":"1996","journal-title":"Genitourin Med"}],"container-title":["Clinical and Experimental Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ced\/advance-article-pdf\/doi\/10.1093\/ced\/llae448\/60893596\/llae448.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/50\/2\/412\/60893596\/llae448.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/50\/2\/412\/60893596\/llae448.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T10:57:51Z","timestamp":1737975471000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ced\/article\/50\/2\/412\/7831870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,23]]},"references-count":7,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,10,23]]},"published-print":{"date-parts":[[2025,1,27]]}},"URL":"https:\/\/doi.org\/10.1093\/ced\/llae448","relation":{},"ISSN":["0307-6938","1365-2230"],"issn-type":[{"value":"0307-6938","type":"print"},{"value":"1365-2230","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2024,10,23]]}}}