{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T06:24:08Z","timestamp":1773728648950,"version":"3.50.1"},"reference-count":7,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,2,24]],"date-time":"2015-02-24T00:00:00Z","timestamp":1424736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Primary syphilis caused by <jats:italic>Treponema pallidum<\/jats:italic> usually develops after sexual contact as an initial solitary sclerosis or hard chancre in the genital region. We describe a case of primary syphilis at three sites in genital and extragenital regions of a man who had sex with men. A 29\u2010year\u2010old man visited our hospital for skin lesions on his lower lip, nipple\u2013areola and penis. A positive syphilis serological test for rapid plasma reagin had a titer of 1:16; the patient also tested positive for specific antibodies against <jats:italic>T.\u00a0pallidum<\/jats:italic>, with a cut\u2010off index of 39.0. Histopathological examination of a nipple\u2013areola biopsy specimen revealed a thickened epidermis and dense infiltration of inflammatory cells extending from the upper dermal layers to the deep dermis. The inflammatory cells were composed of abundant lymphocytes, plasma cells, histiocytes and neutrophils. Immunohistochemical staining for <jats:italic>T.\u00a0pallidum<\/jats:italic> using an anti\u2010<jats:italic>T.\u00a0pallidum<\/jats:italic> antibody showed numerous spirochetes in the lower portion of the epidermis, scattered inside inflammatory cell infiltrate and perivascular sites throughout the dermis. Based on these findings, the patient was diagnosed with primary syphilis. Treatment with oral amoxicillin hydrate was started. Five days after starting treatment, a diffuse maculopapular rash (syphilitic roseola) occurred on his trunk and extremities. Perivascular cuffing due to <jats:italic>T.\u00a0pallidum<\/jats:italic> was present throughout the dermis in the biopsy specimen of a localized lesion of primary syphilis. Moreover, syphilitic roseola, which indicates generalized dissemination of <jats:italic>T.\u00a0pallidum<\/jats:italic>, developed during the course of treatment for primary syphilis. Therefore, we considered perivascular cuffing to be indicative of the dissemination phase.<\/jats:p>","DOI":"10.1111\/1346-8138.12818","type":"journal-article","created":{"date-parts":[[2015,2,24]],"date-time":"2015-02-24T10:44:17Z","timestamp":1424774657000},"page":"515-517","source":"Crossref","is-referenced-by-count":15,"title":["Multiple primary syphilis on the lip, nipple\u2013areola and penis: An immunohistochemical examination of <i>Treponema pallidum<\/i> localization using an anti\u2010<i>T.\u00a0pallidum<\/i> antibody"],"prefix":"10.1111","volume":"42","author":[{"given":"Hidetsugu","family":"Fukuda","sequence":"first","affiliation":[{"name":"Department of Dermatology Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misaki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiichi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Dermatology Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiaki","family":"Oharaseki","sequence":"additional","affiliation":[{"name":"Department of Pathology Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Mukai","sequence":"additional","affiliation":[{"name":"Department of Dermatology Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,2,24]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2005.01.015"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1786"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1355"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAI.0b013e3181788186"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000239970"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(04)01061-8"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/513427"}],"container-title":["The Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1346-8138.12818","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.12818","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T19:28:11Z","timestamp":1695497291000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1346-8138.12818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,24]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.1111\/1346-8138.12818"],"URL":"https:\/\/doi.org\/10.1111\/1346-8138.12818","archive":["Portico"],"relation":{},"ISSN":["0385-2407","1346-8138"],"issn-type":[{"value":"0385-2407","type":"print"},{"value":"1346-8138","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,24]]}}}