{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:19:19Z","timestamp":1783473559472,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Secondary syphilis has a wide range of clinicopathological presentations. Diagnosis is aided by detection of spirochetes in tissue or serologic studies. Here, we describe histopathological features of a series of cases of secondary syphilis at our institution to assess if any patterns are typical of cases with positive spirochete immunohistochemistry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A search of our dermatopathology database from 2016 to 2023 was performed for cases of secondary syphilis. Available H&amp;E\u2010stained slides, spirochete immunohistochemistry, and patient information were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010three biopsies from 27 patients were included. Four epidermal reaction patterns were observed, with acanthosis (36.4%), a flattened epidermis (21.2%), and normal epidermis (18.2%) being the most common changes. Granulomas were present in 42.4%, and eosinophils were noted in 18.2%. 87.9% of specimens had plasma cells. Six dermal reaction patterns were identified. 39.4% showed vacuolar interface changes without prominent inflammation, while 18.2% showed lichenoid inflammation. 81.8% of samples stained positive for spirochetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although secondary syphilis is typically thought to have elongated rete with a lichenoid infiltrate with plasma cells, there is a broad range of possible epidermal and dermal inflammatory cells and reaction patterns. Secondary syphilis should be considered for a wide spectrum of inflammatory disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cup.70113","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T09:05:08Z","timestamp":1775639108000},"page":"724-730","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Histopathological Features of Secondary Syphilis: A Case Series"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4424-423X","authenticated-orcid":false,"given":"Ailish","family":"Hanly","sequence":"first","affiliation":[{"name":"Department of Dermatology Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Pathology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gauri","family":"Panse","sequence":"additional","affiliation":[{"name":"Department of Dermatology Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Pathology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy","family":"Myung","sequence":"additional","affiliation":[{"name":"Department of Dermatology Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Pathology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2270-2524","authenticated-orcid":false,"given":"Christine J.","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Dermatology Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Pathology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(22)02348\u20100"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6922a1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.07.011"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.08.062"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000502641"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1973.01620180027008"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13061603"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.4081\/dr.2021.8830"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20104632.2007.03438.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0190\u20109622(86)70173\u20104"},{"issue":"5","key":"e_1_2_8_12_1","first-page":"399","article-title":"Secondary Syphilis. 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